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Northern Hills Baptist Church
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First Name (
Required
)
Last Name (
Required
)
Email (
Required
)
Mailing Address (
Required
)
Date of Birth (
Required
)
Gender (
Required
)
Male
Female
Are you married? (
Required
)
Married
Single
Widowed
What is your spouse's name?
(Both spouses will need to complete an application.)
Have you repented and trusted Christ as your Lord and Savior? (
Required
)
Yes
No
Not sure
If yes, when?
Have you been baptized by immersion? (
Required
)
Yes
No
Are you currently a member of a church? (
Required
)
Yes
No
If so, provide an e-mail address, name, and city of the church.
Have you attended the New Members class? (
Required
)
Yes
No
Partially
Why do you want to join Northern Hills? (
Required
)
What is your occupation? (
Required
)
Please list any children and their dates of birth.
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