First Name * Last Name * Email * Phone * Address * Birthday Wedding anniversary The reason I came today * Salvation (I have never prayed to receive Christ and become a Christian)
Rededication (I am a Christian, but I needed to rededicate myself to the lord)
Membership (I want to be a member of New Hope)
I want to be baptized
To receive prayer
Other reasons for joining Male or Female * Male
Female
Spouse's birthday Have you been baptized? Yes
No