PARK HILLS ASSEMBLY MEMBERSHIP APPLICATION
WE NEED AN APPLICATION FILLED OUT FOR EACH ADULT WHO WANTS TO BECOME A MEMBER. ParkHillsAssembly.com / 3143756341 
Email *
Page 1
Page 2
Full Name *
Cell Phone *
Email *
Address *
City *
State *
Zip Code *
Birth Date *
Marital Status *
Spouse and/or Children's names *
The year I became a Christian *
Please list the past 3 churches / locations that you regularly attended. (attended weekly, attended longer than 6 months consecutively, and served in.) *
Are you currently a member of another church? If so what is it's name and location?  *
 Have you held positions of leadership or serve in ministry at other churches? Please describe.   *
Please describe how you experienced Jesus and in what ways you were changed by him.  *
MEMBERSHIP AGREEMENT
I UNDERSTAND THE INFORMATION ON THIS FORM WILL BE USED INTERNALLY (PASTOR AND BOARD ONLY) FOR THE PURPOSE OF MEMBERSHIP EVALUATION AND I VERIFY THAT I HAVE FILLED OUT ALL OF THE INFORMATION ON THIS FORM HONESTLY AND TO THE BEST OF MY KNOWLEDGE. I AGREE TO THE MEMBERSHIP AGREEMENT ON PAGE 2, AND I HAVE LOOKED OVER THE FUNDEMENTAL TRUTHS ON PAGE 1.   
BY TYPING YOUR NAME HERE YOU AGREE AND ARE DIGITALLY SIGNING THIS DOCUMENT *
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