Ossington Pentecostal Church - Membership Request

Membership Application

Confidentiality Of Information

First Name

Last Name

Birthdate

Marital Status

Email

Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Gender

Do you currently hold membership in another church

Yes

No

How long have you attended Ossington Pentecostal?

Have you attended Ossington for the pat three consecutive months?

Yes

No

Please provide the name of a current member of OPC as a reference

First Name

Last Name

When did you decide to follow Jesus Christ

Have you been baptized in water by immersion?

Yes

No

Date Input

Where were you baptized?

Since you have not been baptized. Are you willing to be baptized?

Yes

No

Have you been baptized in the Holy Spirit?

Yes

No

When were you baptized in the Holy Spirit?

If not, are you earntly seeking the Baptism of the Holy Spirit

Yes

No

Signature