Campbell Street Church - Information Sheet

Personal

First Name

Last Name

Middle Name

Preferred Name

Address 1

Address 2

Country

City

State

Zip/Postal Code

Cell Phone Number

Home Phone Number

Work Phone Number (If You Can Be Reached)

Primary Email Address

Secondary Email Address

Date of Birth

Allergies/Health Concerns

Occupation

Employer

Are You A Christian?
Yes
No

If So, When Did You Become a Christian?

Are You In A LifeGroup?
Yes
No

If So, Which One?

Family

Marital Status
Married
Single
Divorced
Widowed

Anniversary

Spouse's First Name

Spouse's Last Name

Middle Name

Preferred Name

Are They Already a Member At Campbell Street?
Yes
No

If Not, Are They Wanting to Also Place Membership At This Time?
Yes
No

Are They A Christian?
Yes
No

If So, When Did They Become a Christian?

Spouse's Phone Number

Spouse's Email Address

Spouse's Date of Birth

Spouse's Allergies/Health Concerns

Spouse's Occupation

Spouse's Employer

How Many Additional Members of Your Household Are There?

Please List Their Name(s), Gender(s), Date(s) of Birth, School(s), and Grade(s) Below:

I consent to having images taken at Campbell Street events of me and/or my family used for Campbell Street's marketing; including their website, social media platforms, and mobile app.
I Consent
I Do Not Consent

WELCOME TO THE FAMILY

Membership Information Sheet

Personal

Family