Wieuca Road Baptist Church: Home: Becoming a Member of Wieuca

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First Name *

Middle *

Last Name *

Email Address *

Birthday *

Address Line 1 *

Address Line 2

City *

State *

ZIP Code *

Home Phone *
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Fax Phone
( ) - ext.

Work Phone
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Mobile Phone
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What is your relationship status? *

Single

Divorced

Widow(er)

Married/Partner

How many, if any, children are still under your care?

0
1
2
3
4
5
6
7 or more

I am intersted in...

Becoming a Member

Speaking with the Pastor about Membership

Getting More Information About WRBC

I would like to join Wieuca Road Baptist Church by...

Profession of Faith

Believers Baptism

Transferring Membership from another Church

Are other members of your family interested in joining as well? *

Yes

No

Please list full names, birthdates, and way in which family members seek to join (baptism, transfer, etc.).

In addition to information about joining WRBC, please send me information about...

Sunday School Classes

Small Groups

Support Groups

Singles Activities

College Activities

Senior Adult Activities

Children's Ministries

Adolescent Ministries

Mission Activities

Volunteer Opportunities @ WRBC

Other

What other information may we provide for you?

How many times have you participated in worship at Wieuca? *

0

1

2

3

4 or more

Are you currently participating in a spiritual formation group (Sunday School, small group)?

Yes

No

No, but I'd like suggestions on a good group to visit

Please let us know what class you've been attending, if applicable.

Please tell us about any additional information you would like to provide us/receive from us not covered in this form

Multiple family members wishing to join at the same time only need to fill out one form. Thank you.