EVANGELISM MINISTRY FORM

Today’s Date:
MM slash DD slash YYYY
Name*
First Middle Last
Gender
- Male
- Female
DOB
MM slash DD slash YYYY
Age
(If New Member is a minor (under 18 years of age), please ask for name of Parent/Guardian)

Parent(s)
Address: ( Please include apartment number and Zip Code )
Apartment No. Street City State / Province / Region ZIP / Postal Code
Cell#:
Alternate#:
Email
Former Church
How is the New Member joining the Bethany Church family?
- Candidate for Baptism
- Christian Experience
- Other, specify:
Counselor: Please schedule tentative appt for first E-Ministry Team visit at the church, Also, inform New Member that E-Ministry will confirm the appt.
Day
Date
MM slash DD slash YYYY
Time

: Hours

Minutes

AM/PM
Counselor’s Comments:
CAPTCHA