New Membership Application & Contact Information

Eternal Life Church
Mission:
To be a church that Seeks, Saves and Serves
-Seek God and His peoples
-Save peoples through Christ
-Serve Christ and each other
-To Seek, to Save, to Serve is to Love

Vision
Display the glory of Christ
John 17:22 – 22 I have given them the glory that you gave me, that they may be one as we are one

Legal Name

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Preferred Name

Hmong Name

Spouse Name

Gender

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Please select one option.

Male Female

Address

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Phone

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Email

This address will receive a confirmation email

Marital Status

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Please select one option.

Single Licensed Marriage Traditional Marriage Divorce Widowed Separated

Date of Birth

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Have you Accepted Jesus as your Savior?

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Yes No

Are you Baptized?

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Please select one option.

Yes No

Family

Dependent 1 Name

Dependent 1 DOB

Dependent 1 Gender

Please select one option.

Male Female

Dependent 2 Name

Dependent 2 DOB

Dependent 2 Gender

Please select one option.

Male Female

Dependent 3 Name

Dependent 3 DOB

Dependent 3 Gender

Please select one option.

Male Female

Dependent 4 Name

Dependent 4 DOB

Dependent 4 Gender

Please select one option.

Male Female

Additional Dependents

Description

Eternal Life Church
Mission:
To be a church that Seeks, Saves and Serves
-Seek God and His peoples
-Save peoples through Christ
-Serve Christ and each other
-To Seek, to Save, to Serve is to Love

Vision
Display the glory of Christ
John 17:22 – 22 I have given them the glory that you gave me, that they may be one as we are one

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