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Date of Birth:
Spouse's Date of Birth:
Children Attending Mt. Zion (with dates of birth):
Are you a church member?
If yes, where?
Have you been baptized by immersion following your commitment to Jesus?
If yes, where and when?
If you have not been baptize, are you wiling to submit to baptism by immersion as a requirement for church membership?
If you have held membership at previous churches, please name the churches with approximate dates:
What areas of service have you been involved at another church? (Deacon, teacher, missions, children's ministry, etc.):
What areas of service would you be interested in as you get involved at Mt. Zion?
Briefly provide your testimony of faith in Jesus Christ: