Become A Member – KORLE BU COMMUNITY CHAPEL

Personal Info

Surname

Other Names

Sex
Male Female

Date of birth

Date Test

Year of Conversion (if known)

Hometown

Place of birth

Present Residential Address

Present Postal Address

Email

Telephone

Marital Status

Date Married

Profession / Job Title

Name of Organization

Location of Workplace

Hobbies / Interests

Abilities You Could Serve the Church With

Spouse's Info

Spouse's Fullname

Spouse's Residential Address (if different)

Occupation

Christian Status (Born again?) Yes No Don’t Know

Dependant’s Details

FIRST DEPENDANT

Name

Age

Sex
Male Female

Date of birth

SECOND DEPENDANT

Name

Age

Sex
Male Female

Date of birth

THIRD DEPENDANT

Name

Age

Sex
Male Female

Date of birth

FOURTH DEPENDANT

Name

Age

Sex
Male Female

Date of birth

Parents Details

Father's name

Born again?

If alive, present address

Mother's name

Born again?

If alive, present address

Previous Church/Fellowship Details

Previous Church Name & Location

Have You Been Baptised in Your Church?
Yes No

Have You Been Confirmed in Your Church?
Yes No

Offices Held or Parts Played in Your Church of Which You Were a Member

Fellowships/Societies outside Your Church of Which You Are a Member

Membership Form