Page 26 | Rehoboth. Jacksonville

APPLICATION FOR CHURCH MEMBERSHIP

Greetings in Jesus’ Name,

Thank you for taking the time to fill out this application for Membership at Rehoboth. Jacksonville! Church membership is vital to your spiritual growth. Our desire is that we grow together in love, maturity, and Christlikeness. Let's commit ourselves to one another.

Together, we are stronger! Together, we reflect Christ’s image fully! Together, we can make Jesus Famous to the World!

Blessings to you,

Pastors Eric S. & Kenya J. Miller

Which Rehoboth Jacksonville location would you like to join? (Required)

Your Name ( First Name and Last Name (Required)

Date of Birth (Required)

Telephone Number (Required)

Enter N/A if not applicable

Cell Carrier (Required)

ex: Verizon, T-Mobile, or Select "N/A" if not applicable

Email Address (Required)

Address (Required)

ex: 1234 Main Street

City (Required)

State (Required)

Zip Code (Required)

Marital Status (Required)

Spouse's Name (Required)

ex: John Doe OR Enter N/A if not applicable

Marriage Anniversary

Are you relocating from another area? (Required)

Were you a member of a church there? (Required)

If "Yes", please enter the church's name. Otherwise, please enter "N/A" (Required)

Have you accepted Jesus Christ as your Savior? (Required)

Date you accepted Jesus Christ as your Savior?

Were you baptized in water? (Required)

If applicable, what date were you baptized in water?

Have you been baptized in the Holy Spirit? (Required)

If applicable, what date were you baptized in the Holy Spirit?

Are you currently taking any prescription / non-prescription drugs?

Were you ever convicted of a sexual crime?

If ever convicted of a sexual crime, please enter date below

Please tell us about any areas of ministry in which you would consider serving

Please use this space to describe your Spiritual goals.

Please type your First and Last name below to electronically sign this application (Required)

Rehoboth Jacksonville

3040 Gilead Dr, Jacksonville, FL 32254

(904)619-2696

Rehobothjadm@gmail.com

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