Become A Member Form | Greater New Birth Church

Let us know that you would like to become a Member by completing the form below.

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

Have you been an active member of Greater New Birth Church in the past 90 days?

Would you like to reinstate your membership?

Please select which Greater New Birth Location you'd like to join

Have you been Baptized?

If no, would you like to be a candidate for Baptism?

Title *

First Name *

Last Name *

Email Address *

Phone Number *

Address

Date of Birth

Are you under the age of 18? *

Marital Status (choose one)

Emergency Contact Info (Information only used if you would require medical attention while attending services.)

First Name and Last Name

Relationship To You

Phone Number