Bethel Prayer Fellowship International. UK.

www.bethelpfi.org
bethelprayer17@gmail.com
Charity Reg. No. 1174777

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CHURCH MEMBERSHIP APPLICATION FORM

PLEASE COMPLETE THIS FORM CLEARLY. Branch: HARLOW

PERSONAL DETAILS

Full Name *

Your Previous Name

Date of Birth *

Place and Country of Birth *

Sex

Male Female

Present Address in UK *

Permanent Address (Native), including phone no.

Name of Father

Name of Mother

Nationality *

Phone No. *

E-mail ID *

Date of Marriage

Full Name of Spouse

Child's Name 1

Child's Name 2

Child's Name 3

Child's Name 4

Bethel Prayer Fellowship International. UK.

www.bethelpfi.org
bethelprayer17@gmail.com
Charity Reg. No. 1174777

FAITH AND CHURCH DETAILS

YOU MUST PROVIDE DETAILS OF AT LEAST ONE REFERENCE.

REFERENCE 1

Referee Name & Address *

Referee Contact Number *

REFERENCE 2

Referee Name & Address

Referee Contact Number

DECLARATION

I hereby declare that all the information given above is true and correct to the best of my knowledge. I will comply with the requirements for the edification of church and will be a faithful and fully dedicated member in following all the terms and conditions of the church.

Applicant Name *

Date *

Place *

Signature of Applicant *

Bethel Prayer Fellowship International. UK.

www.bethelpfi.org
bethelprayer17@gmail.com
Charity Reg. No. 1174777

FOR OFFICE USE ONLY

Branch

Date of Application Received

Decision of the Church Committee

Witness 1 — Name

Witness 1 — Designation

Witness 1 — Contact

Witness 2 — Name

Witness 2 — Designation

Witness 2 — Contact

Registration No. with Year

Date

Name & Signature of the Pastor

Privacy: Your personal information will be kept strictly confidential and will not be disclosed with any other third party.

NOTE: Applicants need to give proof of identity (e.g. passport / driving licence etc).