Membership Application

1380 S. Valley Forge Rd. Lansdale, PA 19446 Phone: 215.368.4444 Email:

First Name
Last Name
Postal Code
Email Address
Cell phone Number
Child 2 Name
Marital Status
Child 1 Grade and School
Spouse's Name
Child 2 Grade and School
Child 1 Name
Child 3 Name
Child 3 Grade and School
Child 4 Name
Child 4 Grade and School
Please provide a brief written statement of your personal story of coming to faith in Christ

Former Church
Pastor of Former Church
Address of Former Church
Phone Number of Former Church
I have read the church constitution

Are Required Fields