Enter into His gates with thanksgiving, and into His courts with Praise. Psalm 100:4 Title Select TitleRev.Mr.Mrs.Ms.Youth First and Last Name(Required) Address(Required) Apartment Number City (Required) State(Required) Select StateAlabama: ALAlaska: AKArizona: AZArkansas: ARCalifornia: CAColorado: COConnecticut: CTDelaware: DEDistrict of Columbia: DCFlorida: FLGeorgia: GAHawaii: HIIdaho: IDIllinois: ILIndiana: INIowa: IAKansas: KSKentucky: KYLouisiana: LAMaine: MEMaryland: MDMassachusetts: MAMichigan: MIMinnesota: MNMississippi: MSMissouri: MOMontana: MTNebraska: NENevada: NVNew Hampshire: NHNew Jersey: NJNew Mexico: NMNew York: NYNorth Carolina: NCNorth Dakota: NDOhio: OHOklahoma: OKOregon: ORPennsylvania: PARhode Island: RISouth Carolina: SCSouth Dakota: SDTennessee: TNTexas: TXUtah: UTVermont: VTVirginia: VAWashington: WAWest Virginia: WVWisconsin: WIWyoming: WYPuerto Rico: PRVirgin Islands: VI Zip Code (Required) Home Phone Number Work Phone Number Cell Phone Number E-mail Address Birthday (xx/xx/xxxx) Make The Following Public Commitment(Required) Accepts Jesus Christ As Personal Lord and SaviorDesires Membership in this Church:By BaptismBy LetterChristian ExperienceRededicates Life to Jesus ChristReinstatement United During 6:30 Service P.M.7:30 Service A.M.10:45 A.M. ServiceOther Date & Time Other Date & Time Previous Church Previous Church Address Previous Church State Select StateAlabama: ALAlaska: AKArizona: AZArkansas: ARCalifornia: CAColorado: COConnecticut: CTDelaware: DEDistrict of Columbia: DCFlorida: FLGeorgia: GAHawaii: HIIdaho: IDIllinois: ILIndiana: INIowa: IAKansas: KSKentucky: KYLouisiana: LAMaine: MEMaryland: MDMassachusetts: MAMichigan: MIMinnesota: MNMississippi: MSMissouri: MOMontana: MTNebraska: NENevada: NVNew Hampshire: NHNew Jersey: NJNew Mexico: NMNew York: NYNorth Carolina: NCNorth Dakota: NDOhio: OHOklahoma: OKOregon: ORPennsylvania: PARhode Island: RISouth Carolina: SCSouth Dakota: SDTennessee: TNTexas: TXUtah: UTVermont: VTVirginia: VAWashington: WAWest Virginia: WVWisconsin: WIWyoming: WYPuerto Rico: PRVirgin Islands: VI Previous Church Zip Code Person Filling Out Form(Required) Greeter Diaconate