Membership

Personal Information
Your Name
First Last
Spouse's Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Work Phone
Home Phone
Email
Marital Status
Anniversary Date
Date Format: MM slash DD slash YYYY

Additional Information
Date you started attending Harvest Muskoka
Date Format: MM slash DD slash YYYY
Baptism*
- I am requesting baptism. Please contact me for the next baptismal service.
- Yes, I have been baptized (believers baptism) in the name of the Father, Son and Holy Spirit after conversion, as a testimony to my faith in Christ.
When?
Date Format: MM slash DD slash YYYY
Where?
Harvest Essentials
- I have completed all three Harvest Essentials classes.
Date
Date Format: MM slash DD slash YYYY
Previous Church Membership
- Yes, I have previously been a member of another church.
What is the name of the church(es), and when did you last attend (approximately)?
Are there any outstanding issues between you and the leadership/members of any previous churches?

Household Information
Please complete the following information for our church database. It is helpful to have as much information as possible, but feel free to omit any information that you are not comfortable providing to us. None of this information will be shared with any outside organization.
Head of Household
Name Date of Birth Cell Number Email Address
Spouse
Name Date of Birth Cell Number Email Address
Child
Name Date of Birth Cell Number Email Address
Additional Information
(summer or college addresses, children or spouse with different last name, anything else you would like us to know)

Consent Release
By signing this form, you give your consent to Harvest Bible Chapel Muskoka to use this information for the purposes of its operation.
Date
Date Format: MM slash DD slash YYYY
Signature

My Story
1. “I was...”
What was your life like before you accepted Jesus Christ as your Lord and Saviour?
2. “But God...”
How did you come to surrender your life to Jesus Christ?
3. “And now...”
What is the Lord doing in and through your life now?

Walk with Christ
Small Group
- I am already in a Small Group
- I’m not in a Small Group; please assign one to me!
Small Group that I am a part of
Work for Christ
Areas you are currently serving
Areas you are interested in serving
Giving
Interested in Pre-authorized Giving
- Yes
- No
Doctrinal Statement
Please Read Our Doctrinal Statement (myharvestchurch.ca>about>what we believe>doctrinal statement)
- I have read and will submit to the doctrinal statement

Name	Date of Birth	Cell Number	Email Address

Name	Date of Birth	Cell Number	Email Address

Name	Date of Birth	Cell Number	Email Address

Personal Information