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?

Would you like to be a candidate for Baptism?

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

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