Membership Application Name * First Name Last Name Email * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Add me to the Church email list Yes No Phone (###) ### #### Birth date MM DD YYYY Marital Status Divorced Single Married If married, spouse's name * Children's Names & ages * Have you been baptized? Yes No If you have not been baptized, when can you take this step? * What worship service do you normally attend? * 9:00am 10:45am Would you like to have an FCC Connector: an individual or family who will connect with you and help you meet other people at FCC and get connected with the church * Yes No Faith Statement: Thank you!