New Member Intake Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

As you answer the questions below, you will be automatically filling out the Metropolitan Community Church new member form which will be submitted to our Church Office for processing. This should take approximately 5 minutes. It must be done in one session as the form cannot be saved. Please complete the form below in its entirety, where applicable. Mandatory fields are marked* Please do not use ALL CAPS.

Date Joined *

YYYY

Joining As *

New Believer (desiring to be baptized by full immersion)

Experienced Christian (previously baptized by full immersion)

Requesting Membership Restoration (previous Member of Metropolitan)

E-Member (desiring to connect with Metropolitan but live outside IL)

Are you Head of Household? (married OR over 18 and the only member of your household) *

Yes

If NO, specify Family Position

Spouse

Child (under 18 years old)

Other (over 18 years old living in family home)

Clear selection

Parent Name (if child under 18)

Title *

Mr.

Mrs.

Ms.

Miss

Master

Dr.

Rev.

Rev. Dr.

Minister

Full Name *

Full Address (street, apt. #, city, state, zip) *

Primary Phone (mobile preferred) *

Secondary Phone

Email *

Date of Birth (month, day & year) *

YYYY

Marital Status *

Single

Married

Separated

Divorced

Widowed

Engaged

If Married, Spouse Name

Is Spouse a member of Metropolitan Community Church?

Yes

Pending

Clear selection

Emergency Contact Name *

Relationship *

Spouse

Parent

Sibling

Friend

Other:

Emergency Contact Phone *

List other relatives that are members of this church, but do not live in your household. PLEASE INDICATE RELATIONSHIP

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms