Membership Intake Form

Name *
Name
Membership Expectations *
Having trusted in Christ alone as my Lord and Savior, and being in agreement with the Vision, Mission, Creed, Core Values, and Structure of Coffee Creek Church, I desire to unite to the Coffee Creek family. In doing so, I commit myself to Jesus Christ and to the other members of the family, to protect our unity, faithfully attend, financially support, and serve the ministry of my church family as outlined in the membership class, which I acknowledge I have just completed.
Your Date of Birth
Your Date of Birth
Home Address
Home Address
Cell Phone
Cell Phone
Have you been baptized as an adult?
Name, Relation to you, (Grade & Schools if applicable), Birthdate, (Anniversary Date if applicable), and email/cellphone.