APPLICATION FOR CHURCH MEMBERSHIP MR. MISS. é K 4 j UCK S ZIP RESIDENCE MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH DATE $-/2 CODE NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED () ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. () DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM YES A pay __ YEAR ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION ps O FOR CLERK’S USE ONLY NO _____ ; BY STATEMENT : ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION R34 ZIP CODE ( ) BY LETTER FROM ( SF PHONE 273 ZIP CODE PHONE ZIP CODE Y . (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS DATE BATES) Looe LETTER REC'D f APPLICATION FOR CHURCH MEMBERSHIP di Ber DA 5% =~ CE RESIDEN / McBaipe i) F250 sure P22 O- PF Roy YO MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH \/) a O TOBE R DAY cope 2YC67 _puone_7 26ST 7 ZIP CODE PHONE if vear NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. (I DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM YES y ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION JIVE o , FOR CLERK’S USE ONLY DATE -f worn st 4 TK _— LETTER REC’D NO ____ - BY STATEMENT ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION . —_ ZIP CODE ( ) BY LETTER FROM (_ ZIP CODE (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS ; a a“ f MR Miss. APPLICATION FOR CHURCH MEMBERSHIP ) PI OG pesience | — Pea <K OTS L779 4 eS i Ni ~% Se rt A fyi , ain 7 f | wath Hot 4 Je 5S, e MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH ZIP DATE CODE PHONE ZIP CODE PHONE DAY YEAR NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ZIP CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ____, YES ; () ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( ) BY LETTER FROM ZIP CODE FOR CLERK’S USE ONLY _) DATE BAPTIZED 4 ; BY STATEMENT 7 1K y l f ; | DATE LETTER REC’D ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS ) /IGG / APPLICATION FOR CHURCH MEMBERSHIP mS “Rrandon RESIDENCE _Job al, Bed Corps MAILING ADDRESS (IF DIFFERENT) ford, wre atl lark Cleartield — €-Dorm BUSINESS ADDRESS BIRTHDATE: MONTH W arch. DAY COE PHONE ZIP CODE PHONE 13 ZA YES ZIP CODE FOR CLERK’S USE ONLY \o DATE BAPTIZED ; | pate LETTER REC'D ; BY STATEMENT () BY LETTER FROM ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION 774 -4OOO ZIP CODE vear £9 °7T NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (J ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( Wf DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM Dt (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP Giz) . miss INGevim RESIDENCE. ~JO Wilten . Corps, Cleartield MAILING ADDRESS (IF DIFFERENT) A — CODE pHone.¢ ZIP CODE PHONE - Dpacm BUSINESS ADDRESS BIRTHDATE: MONTH Jun <. ZIP DATE DAY >. vear NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( Wf ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( Wf DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM YES oe ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION 19 ER FOR CLERK’S USE ONLY NO DATE BAPTIZED ; | pare LETTER REC’D ; BY STATEMENT ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ZIP CODE 4-YOOO ZIP CODE ( ) BY LETTER FROM (_ 7 (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS hid [44 © Ww yor, MARCUS Haars SQW BeD sbah 9) WNNg OS FReRRS CA Fen, : C[eaheld Sob Cores Comey Dowem G . Y 4 / 2eee (J ys | S / 1 4® L7 iC .A4 O O b2 /' Application for Membership Date ! 0 - of eet G y Birthday 8 Month | X/ Day Year As a follower of Jesus Christ, desiring to obey him, | hereby apply for membership in this church. | promise that with God's help | will endeavor to fulfill the ‘Vital Membership Requirements, ' and to carry out the church covenant. Furthermore, as God may prosper me, | will contribute to the support of the church and its missionary program, and do all in my power to yaa its peace and progress. (Signed) Mr) Mrs., ae Residence Address | of barnermn AQ mes. Street ; w 87S LO. Phone 7 d Zip | UL _ & U A C| : Business Address | desire to join U Letter L] From the Judson Press Mei 5 21 ev Name of Church Reaffirmation of Faith () church of Baptism € —__ Agder "City 55-0030 dL REQUIREMENTS OF VITAL CHURCH MEMBERSHIP 1. | will attend the worship services of the church with faithful regularity in so far as | am able. and will invite others to attend with me. 3. | will make my offering to God regularly and in proportion to my income. as a faithful steward of jesus Christ. 4. | will pray regularly for my church, my pastor. and my fellow members: and for my acquaintances who do not yet know Christ as their Saviour. Birthplace Ate Wedding Date where Hed Aone bo Where Relatives Who Are Members Approx. Other Relatives Attending Church Approx. of this Church School *C—Child, Y—10-25, YA—25-40, A—40 or over. (ssauppy) sl Age* Age* (auocydayja |) Date Baptized Les, (aweN) 2. | will share in the work of the church. accepting such opportunities for service as my talent. and health will permit. APPLICATION FOR CHURCH MEMBERSHIP ak Dest NY DAusson) RESIDENCE SIO Tay BD FOO So: Roy MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH —_ (7 C7 NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS KRacKheEL DATE IE SPT DAY ___ = PHONE 713 -$7o/ ZIP CODE PHONE year ZIP CODE 7 (p ZIP CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ___, YES ____, NO___ 1) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM — (_) BY LETTER FROM DATE ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION FOR CLERK'S USE ONLY paptizen ; BY STATEMENT _ LETTER REC’D ADDRESS OF CHURCH ( (9 °7 coed tae 7 DAWSON (_ ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. t (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS CO -5 ~ g 7 APPLICATION FOR CHURCH MEMBERSHIP oP Diath RESIDENCE 53 RENTIE KA RR Ce DATE “RT MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH l\ NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS DAY ¢ - CODE PHONE FPF ZIP CODE \ 3 PHONE ZIP CODE ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( ) BY LETTER FROM YES Ry * ZIP CODE Y ; BY STATEMENT DATE BAPTIZED ; | DATE ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. 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( ) OTHER DECISION 66 Fk ZIP CODE ZIP CODE BUSINESS ADDRESS BIRTHDATE: MONTH PHONE FP3- (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS ws MR. - RESIDENCE ~~. APPLICATION FOR CHURCH MEMBERSHIP BYRon 3 G LS. Yor MAILING ADDRESS (IF DIFFERENT) ARmMstRovc K PD en VE K CODE Co PHONE ZIP CODE BUSINESS ADDRESS BIRTHDATE: MONTH MAKES THE FOLLOWING PUBLIC COMMITMENT: (_ ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_ ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. <P DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM YEAR 7 7 4- H Dorm “ob YES NO ___ DATE BAPTIZED x , I [RES (_ ) DEDICATES LIFE FOR CHURCH RELATED VOCATION _ DEN ) REDEDICATES LIFE TO CHRIST. 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NYSeee CODE YEAR ADDRESS OF CHURCH ( ZIP PHONE NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_ ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED _____ YES ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM PHONE =? (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP MVWoNI er esence__/ YO CA - 2 wae (CT DARNES Kh ST MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH {Y} AR ny cope SI UY CS pone s5. ZIP CODE PHONE /G MAKES THE FOLLOWING PUBLIC COMMITMENT: (_ ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. u ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( severe rom ___~_ ADDRESS OF CHURCH CKS YES OW, (VM A) Flo ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION Key ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION 7 O - BY STATEMENT ISS | . D _. T ZIP CODE NO_____ UpPEW ZIP CODE YEAR NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS (ST7 2c E YENS (AREA IF KNOWN) a Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS FOR CLERK’S USE ONLY DATE BAPTIZED ; | pate LETTER REC’D APPLICATION FOR CHURCH MEMBERSHIP MR. Ff | MRS. Ay, c iss CAMICCE . RESIDENCE aS Nie, (3 : , ER OLAC KEN —» wi EZ ACeee Aye Ave MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS > BIRTHDATE: MONTH LX NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: () ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. 7X) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM __ | | YES CF ( pay __ / uP QL otep I-29 2¢/. =Fc SF _= ZIP yc $4404 ZIP CODE | ( ) REDEDICATES LIFE TO CHRIST. 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ZIP ( ) BY LETTER FROM ( [¢, (TF YEAR (sine Kely MAKES THE FOLLOWING PUBLIC COMMITMENT: () ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRISTAS PERSONAL SAVIOUR AND LORD. 4) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM _ FEB. (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP "= DAVID RESIDENCE 33 AZ MAILING ADDRESS (IF BUSINESS ADDRESS Butler TALe DIFFERENT) Ona BIRTHDATE: MONTH , 3 74 DATE ST CODE meld (ff HIER ORAS K A HA Oc T DAY NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRE IK 3 ©) DERM “ LV FEBS, PHONE . ae vear 7 ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. YX DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM = CODE 45/- 562 g %9/- FOR CLERK’S USE ONLY NO ____- DATE BAPTIZED X - BY STATEMENT 3 - DATE LETTER REC’D ( ) BY LETTER FROM ADDRESS OF CHURCH (_ ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION YAO T aCODE \ MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED _____ YES IV GE. (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS i eG x MR. " APPLICATION FOR CHURCH MEMBERSHIP MRS. (/\ miss, bred Le ~K 9 Po) fy id 2 | ; V one RESIDENCE _\ PEARSYVELD whi L Vj A MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ss ZIP KK CODE DAY ZIP CODE ZIP CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ____, YES ____, NO___ a (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. (DX DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ; BY STATEMENT (_) BY LETTER FROM FOR CLERK’S USE ONLY DATE : 3 - | “Fo Seas : | oer LETTER REC'D ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION vf DATE AK iS TO ef / pone Z 7 + SD ZIP CODE PHONE YEAR (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS ? . APPLICATION FOR CHURCH MEMBERSHIP MRS. MISS. RESIDENCE DY “vs MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS — ys BIRTHDATE: MONTHLA ZL 6 NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ZIP CODE sae MAR . APIVS J 4PHONE ZIP CODE DAY YEAR ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED Ye> X CODE PI FOR CLERK’S USE ONLY cmt DATE BapTizen ; BY STATEMENT r ; | pate LETTER REC’D ( ) BY LETTER FROM ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION E3XK) ZIP CODE (_ ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ZIP PHONE MAKES THE FOLLOWING PUBLIC COMMITMENT: ( HA (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS “~ 2 is . a - = — APPLICATION FOR CHURCH MEMBERSHIP “s_LALARPEN TER, TRAN DY RESIDENCE MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ZIP CODE DAY 4 -L= a 4-2 9-¢: PHONE ZIP CODE YEAR FOR CLERK’S USE ONLY DATE BAPTIZED ; | pare LETTER REC’D ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION PHONE ZIP CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ____, YES ___, NO ____ (_ ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. 4,4) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM —__X ; BY STATEMENT () BY LETTER FROM ( ZIP CODE (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP me e MISS G27 t ONS 5 . RESIDENCE LA ELK S/o blo fk MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS Al QO VEMbLEL BIRTHDATE: MONTH NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. (A DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM YES DATE ZIP CODE ZIP CODE pay__| | ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION 4 d ZIP CODE No ; BY STATEMENT FOR CLERK'S USE ONLY t ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION , PHONE TTA - F000 iP CODE PHONE ae fF fo Te (_) BY LETTER FROM ( 3-29-F3 (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS DATE a > | oe LETTER REC'D APPLICATION FOR CHURCH MEMBERSHIP ms Curis it eesipence Blob CRAWFORD sae SPT: 7.197 KEKSHA&) Ze IV OS prone 324 - LIT2 MAILING ADDRESS (IF DIFFERENT) ZIP CODE BUSINESS ADDRESS BIRTHDATE: MONTH /Y} AA K DAY NAME_AND ADDRESS OF NEAREST OF KIN OTHER THAN (ra, AY ZIP CODE «+ EVeELys MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. 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( ) OTHER DECISION © J ZIP ( ) BY LETTER FROM ( ATTA PHONE THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_ ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. (44 DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM (o"7 CODE ZIP CODE BUSINESS ADDRESS /, (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS ms Kt APPLICATION FOR CHURCH MEMBERSHIP DABNEY RESIDENCE LOO | Wh AEtSO MAILING ADDRESS (IF DIFFERENT) ) A SE CODE PHONE ZIP BUSINESS ADDRESS BIRTHDATE: MONTH LOC NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. 0X] DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM se KEB. 22,1 CODE pay _~D Za EK A (_ ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. 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(_) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM LLE (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS , Ss APPLICATION FOR CHURCH MEMBERSHIP MR. MRS. MISS. RESIDENCE ' L. N ; a, ) NX y * MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS N\1 | \‘D AN) | —- | ~ rn ) Y __£\ i a Aa \ | — \; + B OO TZ Joe _f[yyp } A H Dok \ | BIRTHDATE: MONTH | Ut [ > > f / _ Y DATE ( ZIP LY CODE PHONE ZIP CODE PHONE DAY YES FOR CLERK’S USE ONLY NO ____ DATE BAPTIZED ; BY STATEMENT ; | DATE LETTER REC’D ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION (_ ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION ZIP CODE ZIP CODE ( ) BY LETTER FROM ( T YEAR NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_ ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_ ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. , pA DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM XK _ (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS MR. ms MISS. RESIDENCE (YA, APPLICATION FOR CHURCH MEMBERSHIP Treas y ra)> ZFIOIS = f+ i 2 WAD AY] . - Ep ZIP Lolr/Ys MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED _____ YES (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. (SQ DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM 4. ( ) BY LETTER FROM DAY £-2N- DATE _An-RK CODE PHONE ZIP CODE PHONE YEAR ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION TVL4-F000. ZIP CODE ZIP CODE FOR CLERK'S USE ONLY NO ____ DATE BAPTIZED 3- ‘ ~F ‘ + | poe LETTER REC’D By STATEMENT ADDRESS OF CHURCH ( | (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS ” " APPLICATION FOR CHURCH MEMBERSHIP ms DeENETRA RESIDENCE S. F/ / [KB DAW Son vo a see FEBS, 1992 PHONE —__ MAILING ADDRESS (IF “Sz BUSINESS ADDRESS CODE Syz7.0) JERK BIRTHDATE: MONTH —_ CODE _ i DAY NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ( b — DORM DATE BAPTIZED 4-|LETTER REC’D ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION (_ ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION pn FOR CLERK’S USE ONLY NO ____ ) BY LETTER FROM (_ SO ce 1 VSS | Tt MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ____, YES (_ ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. Y (7) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM / | F PHONE 20 27.37 S°[Y2 ¥ (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS g V/ APPLICATION FOR CHURCH MEMBERSHIP MR. , ae hb hut _ hesee— Y + Ellum geswence ALAS C.77 5 _ S 7 /B MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH S23_ NAME AND WAZZ ADDRESS OF Ss REST pan gL) CLI cove LV LO Y PHONE G27 4+ CODE CODE PHONE pay AX ear’ ha 3 Fhe _ OF KIN OTHER THAN ABOVE ADD FES - LH, WA Lippe cone MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( ) BY LETTER FROM Yes FOR CLERK’S USE ONLY NO _____ DATE BAPTIZED ; BY STATEMENT of ; | DATE LETTER REC'D ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION Y 9 Of (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS - ( ~ q L APPLICATION sepals RESIDENCE 42 FOR CHURCH Lh, Co Rey 7" QML em, MEMBERSHIP ZIP A DATE 3-7A- CODE MAILING ADDRESS (IF DIFFERENT) PHONE T, ZIP Beh BUSINESS ADDRESS oe BIRTHDATE: MONTH_SEPTEMBEL om YES YEAR [98 ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION - Yo 00 \ FOR CLERK’S USE ONLY NO _____ DATE BAPTIZED ; | pate LETTER REC’D . BY STATEMENT ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION y ZIP CODE ZIP CODE ( ) BY LETTER FROM ( TS PHONE NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_ ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM 7 (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS S APPLICATION An Hiner: ni RESIDENCE Vorvwn MAILING ADDRESS (IF DIFFERENT) C BUSINESS ADDRESS FOR CHURCH HeKe a Oni mM C Cf’ ed MEMBERSHIP CODE Scio CXUO £0 pate_//PHONE 77 lO a CODE CODE BIRTHDATE: MONTH NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_ ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ____, YES ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. (_) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM PHONE YEAR DAY CODE =n CLERKS USE ONLY NO ____ AP TIZED ; | ote ; BY STATEMENT ( ) BY LETTER FROM — ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) > (Weer Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS ' APPLICATION FOR CHURCH MEMBERSHIP HS RESIDENCE KARL 20 Zi}7 UW Fos (eR _ MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH — h ZIP CODE ” JMIAKCH pay « AO ; ~ GRAND \;RAWD MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_ ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM YES x veam_ MOTHER [OTH ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION S78 7 7 FOR CLERK’S USE ONLY DATE mn sf x paptizeo _/ O° Y : | pate LETTER REC'D NO ___ ; BY STATEMENT ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ? ccCODE ( ) BY LETTER FROM ( ZIP CODE PHONE NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS Cok RINE EK ELLY pHone 7223 1.3 54087 oa Koy Sa: 5ECOD pate 7 -2O- IS (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP -_ - SY RESIDENCE Alc xX ADAMS r KL LL f F L> AAW OHWN RE 4 Y~ 4/] CODE MAILING ADDRESS (IF DIFFERENT) DATE VA ¥ol| 4 ut y DAY SF Vo 18 YEAR __/ ? G5 ZIP CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM YES L— FOR CLERK'S USE ONLY NO ____ DATE BAPTIZED ; BY STATEMENT ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION 2 ; | DATE LETTER REC'D ( ) BY LETTER FROM ( f PHONE NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS (_ ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_ ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. as PHONE 395 -/S 44 ZIP CODE ZIP CODE BUSINESS ADDRESS BIRTHDATE: MONTH ZIP (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS . - APPLICATION FOR CHURCH MEMBERSHIP MR. ait G RESIDENCE TIO REEN, L A fo} VA DATE A _|hisbey [VY “23-297 CODE YY 4 6S prone 392-6459 MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH _ Pec DAY ZIP CODE ZIP CODE PHONE {2 ver LGGI NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ZIP CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. <Q DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( Yeo FOR CLERK’S USE ONLY NO _____ DATE BAPTIZED x ; BY STATEMENT 4 ; | DATE LETTER REC’D ) BY LETTER FROM ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ~~ ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS | _ ( ; j qT j APPLICATION FOR CHURCH MEMBERSHIP ms (GLIF ELA), Eusick ___par RESIDENCE MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH \/4 CODE SHOT PHONE x TAs -0999 ZIP CODE PHONE DAY ZIP CODE YEAR NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ZIP CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED _____, YES ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( ) BY LETTER FROM FOR CLERK’S USE ONLY » Py a | BY STATEMENT DATE BAPTIZED ; | DATE LETTER REC'D ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP m= Recina won SOO Lau KANwes of (4) EST / AqGA CODE MAILING ADDRESS (IF DI ap BUSINESS ADDRESS PHONE ZIP a CODEYAL2 BIRTHDATE: MONTH NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS DAY [ NF A- MAKES THE FOLLOWING PUBLIC COMMITMENT: = (4X) AVC Do CODE FOR CLERK'S USE ONLY DATE BAPTIZED : | oare LETTER REC’D x ; BY STATEMENT () BY LETTER FROM ADDRESS OF CHURCH lsv Com (_ ) DEDICATES LIFE FOR CHURCH RELATED VOCATION (_) REDEDICATES LIFE TO CHRIST. (_ ) OTHER DECISION | L4 Wr 7 Y LA! Ga mi O60 ZIP RM NO _ PHONE 2 JO - Ze 3 J CARE YES ZIP CODE YEAR ~~ (_ ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. $0) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM se FEBAS. [P59 ST" Ca, (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS Date Application for Membership =" - a) CerToBeER ) Je I JAK Birthday IST X COS) Year Day Month As a follower of Jesus Christ, desiring to obey him, | hereby apply for membership in this church. | promise that with God's help | will endeavor to fulfill the “Vital Membership Requirements," and to carry out the church covenant. Furthermore, as God may prosper me, | will contribute to the support of the church and its missionary program, and do all in my power to promote its peace and progress. Hor (Signed) Mr., Mrs., Miss |)A Mo A) Residence Address 9 75 7 9° 9525 I. Aoy : si _uT. treet FM $067 AN Phone 274-6 Y¥2 UE State Zip Business Address | desire to join by Letter L From the Name of Church Reaffirmation of Faith C1 Church Baptism ke of City State Judson Press 55-0030 REQUIREMENTS OF VITAL CHURCH MEMBERSHIP |. | will attend the worship services of the church with faithful regularity in so far as | am able. and will invite others to attend with me. 3. | will make my offering to God regularly and in proportion to my income. as a faithful steward of jesus Christ. 4. | will pray regularly for my church, my pastor. and my fellow members: and for my acquaintances (awe) 2. | will share in the work of the church. accepting such opportunities for service as my talent. and health will permit. who do not yet know Christ as their Saviour. Date Baptized Where Where Relatives Who Are Members Approx. Other Relatives Attending Church School — Approx. Age* of this Church *C—Child, Y—10-25, YA—25-40, A—40 or over. Age* (auoydaje |) Wedding Date (ssauppy) Birthplace APPLICATION FOR CHURCH MEMBERSHIP Css» RESIDENCE DED RA a7 57 HOorFFMA S: J KIAS DATE West Ne f 7 MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH Tu wore LY a! NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN > Geena tdD WE HouPsoN x7 ABOVE ADDRESS —p . Te PHONE L74¢-44 Z¢-L YX ZIP CODE PHONE DA DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ae /. ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION _ copp3O3 99 _ DATE mane ; BY STATEMENT / IneFe : | oare LETTER REC'D ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ZIP FOR CLERK’S USE ONLY YES ____, NO _____ () BY LETTER FROM (_ iS [7 tS be (WrREE Tpaic Cowece free, we ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ZIP CODE YEAR MAKES THE FOLLOWING PUBLIC COMMITMENT: ( “TS. CODE SLT {{ DAY 7-20 (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS | APPLICATION FOR CHURCH MEMBERSHIP De Mies Vo tJ Hou 27 DATE NAR, BROOK RESIDENCE CODE hae PHONE MAILING ADDRESS (IF DIFFERENT) CODE BUSINESS ADDRESS CODE BIRTHDATE: MONTH - gn DAY [ O PHONE YEAR _ x NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS 2 CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: FOR CLERK'S USE ONLY (_ ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_ ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( ) BY LETTER FROM YES NO ____ DATE ol Ji. Ys BAPTIZED _4 o Lb x ; BY STATEMENT ; | DATE LETTER REC’D ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP MR. MISS RESIDENCE TAROM AY O5 | HoLrBROo So 1 30 MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH K UO) DATE MAR, : CODE PHONE ¢79 - ILI CODE T pay CODE os? 22. PHONE YEAR x G NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: ( 27, / 77% on CLERK'S USE ONLY ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. (_) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM X Yes IID cscs DATE 4 <A L 98 paptizen ; | pate LETTER REC'D ; BY STATEMENT (_) BY LETTER FROM ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS 1 APPLICATION FOR CHURCH MEMBERSHIP TE Ho Togys RESIDENCE 470 5S i LW) MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH j CObE CY 40S PHONE ZIP CODE PHONE CG DAY NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE Pa Ss L338 So, CAL Hsp BROOK aff. 275 YEAR W, MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ____, YES (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM —_X ; BY STATEMENT ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST ( ) OTHER DECISION 6 $7 9-3 ZIP CODE [ 2 or CLES FOR CLERK'S USE ONLY DATE ( g -LbBAPTIZED J nate LETTER REC'D NO ___ () BY LETTER FROM ( LT, | ot DATE INAR LBGROOK FOO e (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP MR. mes RESIDENCE MAXRTHEW Y GOS Jb, FOO Hot BROOK LO, CODE MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH Pp DAY ZIP CODE V7 c&) ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( ) BY LETTER FROM YES ZIP CODE YEAR X G ZIP CODE FOR CLERK’S USE ONLY NO ____ DATE - BY STATEMENT f ; | pate LETTER REC’D ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION G g 7 PHONE MAKES THE FOLLOWING PUBLIC COMMITMENT: ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED 7 3 AZ PHONE SY4F05 NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ( XT , 1998 oe LAR (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS 9 Gg APPLICATION FOR CHURCH MEMBERSHIP = TERR Y SopEsS ZIP RESIDENCE ( ADDRESS | OB BIE OF N THE FOLLOWING DAY @ (Speen) KIN OTHER THAN SCHOOL: ALREADY ENROLLED (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP ( ) BY LETTER FROM ABOVE PHONE YEAR ADDRESS IN THIS CHURCH: BY BAPTISM YES ZIP CODE ZIP CODE PUBLIC COMMITMENT: ) ENROLL ME IN SUNDAY ADDRESS PHONE ZIP CODE BIRTHDATE: MONTH MAKES * Ae ~- (IF DIFFERENT) BUSINESS ADDRESS E AND © CODE MAILING ADDRESS N pare_ FOR CLERK’S USE ONLY NO ___ : BY STATEMENT DATE saints x : DATE LETTER REC’D OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP nis. Stermanr ki DD RESIDENCE MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. () DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM YES Fork fRA a \ aa ZIP CODE PHONE ZIP CODE PHONE YEAR ZIP CODE FOR CLERK’S USE ONLY No. DATE BAPTIZED ; | pare LETTER REC'D ; BY STATEMENT (_) BY LETTER FROM ADDRESS OF CHURCH (_ ) DEDICATES LIFE FOR CHURCH RELATED VOCATION (_ ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION ZIP CODE (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP Nic A LBEKT RESIDENCE J68 Co LAUSHAU 4} K (- MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS YoemFiTch BIRTHDATE: MONTH S- [ 7 = D ORM — ; x O PHONE ZIPCODE PHONE DAY ZIP CODE FOR CLERK’S USE ONLY NO ____ - BY STATEMENT ? | ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION ZIP CODE we UY d000 YEAR ( ) BY LETTER FROM ( 774 CODE NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_ ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED _____ YES ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. DX DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM l/-F~F ser L (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS DATE BAPTIZED ; | pare LETTER REC'D APPLICATION FOR CHURCH MEMBERSHIP MR. MRS. Y, MISS. [ SHAW O A) G ZIP CODE RESIDENCE MAILING ADDRESS (IF DIFFERENT) DATE ¢ BIRTHDATE: MONTH DAY _ / Za - PHONE ZIP CODE BUSINESS ADDRESS P 6 ZIP CODE PHONE YEAR NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ZIP CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( ) BY LETTER FROM YES FOR CLERK’S USE ONLY NO ___ DATE LORD. BAPTIZED ; BY STATEMENT ; | DATE LETTER REC’D ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION Skrevevicares LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS "= MR. APPLICATION FOR CHURCH MEMBERSHIP bo PES RESIDENCE B42 £ TE. LS» KV, one 12/2 s/f EA) J A VE. 2 A/ Uo MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ____, YES (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. oA (_) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM 4\—— }a ee BLO¢/ DAY So4 ~T7 0b: ne ZIP CODE PHONE YEAR ZIP CODE FOR CLERK'S USE ONLY NO ____ DATE BAPTIZED ; | pate LETTER REC’D BY STATEMENT () BY LETTER FROM ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ote (AREA IF KNOWN) ) REDEDICATES LIFE TO CHRIST. ) OTHER DECISION Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP ms ERga MR. 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( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM XY PHONE 3BIS~x 3RO (AREA IF KNOWN) ) REDEDICATES LIFE TO CHRIST. ) OTHER DECISION Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS DATE BAPTIZED _ LETTER REC’D APPLICATION FOR CHURCH MEMBERSHIP eo Se a) RESIDENCE N\e Se08 Doar Care DATE PS CODE MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH LO NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. (_) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM PHONE ZIP CODE F DAY [ oT CuU ZIP CODE YES FOR CLERK’S USE ONLY \o ; BY STATEMENT ) DEDICATES LIFE FOR CHURCH RELATED VOCATION R CF O ENGL r ZIP CODE PHONE vear £7 g DATE BAPTIZED ; | pate LETTER REC'D x (_) BY LETTER FROM ADDRESS OF CHURCH 6°K3-9 be é ON) i. 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(DX DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ; BY STATEMENT ( ) BY LETTER FROM ( 2-2-9 DATE (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP € MR. , MISS SAmu eu RESIDENCE ORM NAS H MAILING ADDRESS (IF DIFFERENT) CLEAR BUSINESS ADDRESS H CODE rie Lr do » >) Cork > 7 * KOUS pare__///> 7-27 PHONE = CODE CODE BIRTHDATE: MONTH G DAY | 3 PHONE YEAR TZ T NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ZIP CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. $<) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( a. FOR CLERK’S USE ONLY + DATE BAPTIZED Xx ; BY STATEMENT ; | DATE LETTER REC'D ) BY LETTER FROM ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP ae lawrence RESIDENCE “H&S Nichols jy, LAIR iias DATE ee KYO Yl TF MAILING ADDRESS (IF DIFFERENT) = Ao t Low UU y ae BUSINESS ADDRESS Ce tBrcyep Lye C por t Ne BIRTHDATE: MONTH _/_ 2 pay 725 /0- 26-97 HONE GY LE PE wis cove £40 YO/S pone ZZ2E-/5 32 vear__@8 NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. (SDESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( S YES ZIP CODE PF FOR CLERK’S USE ONLY tes DATE BAPTIZED { CS ; BY STATEMENT ; | DATE LETTER REC’D ) BY LETTER FROM ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION (2REDEDICATES LIFE TO CHRIST ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP MRS. miss, 9 LV A RESIDENCE (> fr fe Lk | ola ; Leer , Mee. ZIP CODE MAILING ADDRESS (IF DIFFERENT) MN ALCH DAY / F , LIT¢- PHONE ZIP CODE BUSINESS ADDRESS BIRTHDATE: MONTH Date oad - | 7 18 ZIP CODE PHONE YEAR f gq TY NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ZIP CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( ) BY LETTER FROM YES 3 FOR CLERK’S USE ONLY NO _____ DATE BAPTIZED ; BY STATEMENT ; | DATE LETTER REC'D ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION : 4000 (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS se _ APPLICATION FOR CHURCH MEMBERSHIP Mas — Nana. Ke S Z SA! — RESIDENCE 027 4 ; A} L.A V7O4 fi MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH DAY NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ____, YES (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD x (_) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM (_) BY LETTER FROM DATE [ af Th g 7 Ot S404) pone bf 7 POC ZIP CODE ZIP CODE PHONE YEAR ZIP CODE FOR CLERK’S USE ONLY NO DATE BAPTIZED ; | pate LETTER REC'D ; BY STATEMENT ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP ic LEGA) RESIDENCE (ATTO Jean Nw DATE CeRPS CODE § 4% ~4E PHONE MAILING ADDRESS (IF DIFFERENT) CODE BUSINESS ADDRESS CODE BIRTHDATE: MONTH 7 DAY i. PHONE [ YEAR vat NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: FOR CLERK'S USE ONLY ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED —____, YES ___, NO ____ ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM () BY LETTER FROM LER ADDRESS OF CHURCH IfTAG VER ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION O x ; BY STATEMENT € ) CUR ST (An DATE BAPTIZED DATE Cn wer V ER, (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS LETTER REC'D Gar MRS. MISS. APPLICATION FOR CHURCH MEMBERSHIP «2 ARS DACL {| RESIDENCE > OWECOS ZIP Jo @ Cor pay__" )9 DATE PHONE PS ZIP CODE PHONE 7 YEAR NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. p<) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM OX ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION ZIP CODE © FOR CLERK’S USE ONLY YES_____ NO____ DATE scenes ; | pare LETTER REC’D . BY STATEMENT ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION f ZIP CODE ( ) BY LETTER FROM ( 9 //- 7. CODE De RV) | MAILING ADDRESS (IF DIFFERENT) CLERR FEI ELD _ 2 BUSINESS ADDRESS —~-/4 CR ATHIENTO BIRTHDATE: MONTH | (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP 85. MaTHINA RESIDENCE 1 t3 Roser rs e* OR ROBINSON oy ZIP CODE B MAILING ADDRESS (IF DIFFERENT) ZIP CODE BUSINESS ADDRESS BIRTHDATE: MONTH “ DAY__ xX b NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. x DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM - BY STATEMENT ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION PHONE L (7s ZIP CODE PHONE £ S FOR CLERK’S USE ONLY DATE 6-4 neorpen SF “/ 7S sere LETTER REC’D ( ) BY LETTER FROM (_ UG . ZIP CODE NO xX A (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP MISS JASON Reeds 6 ZIP CODE RESIDENCE MAILING ADDRESS (IF DIFFERENT) TJToB Co BUSINESS ADDRESS R 7 Lf PHONE DAY G YES YEAR ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION Z ZIP CODE FOR CLERK'S USE ONLY NO___ DATE = BAPTIZED 3 -/G- 7X ; | owe LETTER REC'D - BY STATEMENT ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ZIP PHONE ( ) BY LETTER FROM ( 4118 CODE NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_ ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. PS DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM x AUG, ZIP CODE , BIRTHDATE: MONTH DATE (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP MRS. MISS. _ss c , CT RESIDENCE +0 610 Deep . iL . MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED () ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. (_) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM +f ZIP PLL; FTCODE B44 05 pone ZIP CODE DAY ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION TS. BT S- 14ST. ZIP CODE YEAR ZIP CODE Eel Gitt FOR CLERK'S USE ONLY LOn) YES NO ; BY STATEMENT ao ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION wn, PHONE () BY LETTER FROM ( Il } ~ DATE (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS “| DATE aaerrven » lame LETTER REC'D | (f 1 S 7. ¢ a —_ pplication for Membershi MPG Date nn 1D Month RG ZZ Year As a follower of Jesus Christ, desiring to obey him, | hereby apply for membership in this church. | promise that with God's help | will endeavor to fulfill the ‘Vital Membership Requirements, ' and to carry out the church covenant. Furthermore, as God may prosper me, | will contribute to the support of the church and its missionary program, and do all in my power to promote its peace and progress. (Signeg) Mr.) Mrs., Miss alt Residence Address alo anv % Vv e c \ Corpo Clete: cl — City * Phone treet Zip Business Address | desire to join by Letter [| From the Name of Church Reaffirmation of Faith K Church State x -Ie> Baptism of City State Judson Press 55-0030 REQUIREMENTS OF VITAL CHURCH MEMBERSHIP and will invite others to attend with me. TS WigeS |. | will attend the worship services of the church with faithful regularity in so far as | am able. 3. | will make my offering to God regularly and in proportion to my income. as a faithful steward ol Fisus Christ. (awey) 2. | will share in the work of the church. accepting such opportunities for service as my talent. and health will permit. 4. | will pray regularly for my church, my pastor. and my fellow members: and for my acquaintances who do not yet know Christ as their Saviour. Birthplace 402 FE Wedding Date Wa Relatives ‘ans ALA Where Are Members of this Church | Harn ‘bal, Mo ALA Approx. Age”* Other Relatives Attending Church V/ YA School fed *C—Child, Y—10-25, YA—25-40, A—4O or over. Approx. Age (auoyudaye |) / pre) 499 Where Chlorelh aa 7‘ (ssasppy) Date Baptized APPLICATION FOR CHURCH MEMBERSHIP Miss RoBERT RESIDENCE XE 7 KI IM AU JEF L Do DATE F RSO EC A) MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH 5S 22 (, : al PHONE 3 7 5 ~7H GLO ZIP CODE PHONE DAY ZIP CODE FOR CLERK’S USE ONLY DATE BAPTIZED ; | pate LETTER REC'D (_) BY LETTER FROM ADDRESS OF CHURCH ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION ZIP CODE YEAR MAKES THE FOLLOWING PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ____, YES __, NO ____ | (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. x (I AqyeLf[ec (_) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ; BY STATEMENT ) DEDICATES LIFE FOR CHURCH RELATED VOCATION “Tr CODE E440 / NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ( [© "RG (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS MR. MRS. <omes RESIDENCE APPLICATION FOR CHURCH MEMBERSHIP S HARITA Y RG SM ITH CAP See ITA MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: (_ ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. (>KDESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM XK YES ZIP CODE DAY ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION -F35O ZIP CODE PHONE YEAR ZIP CODE FOR CLERK’S USE ONLY NO ____ DATE BAPTIZED ; | pare LETTER REC'D ; BY STATEMENT ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION HONE SPR sY1Yol (_) BY LETTER FROM ( _ft'e-9 an (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS | Cis RESIDENCE APPLICATION FOR CHURCH MEMBERSHIP oe 9-26-98 TALIAFERRO VIACDA BS / ac? So. MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS ZIP az al SE, copes 2 Len AFIETD AS YES DAY ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION XS ZIP CODE TS CY YEAR ZIP CODE FOR CLERK’S USE ONLY NO____ - BY STATEMENT _” ADDRESS OF CHURCH ) DEDICATES LIFE FOR CHURCH RELATED VOCATION pHonse_ a, PHONE ( ) BY LETTER FROM ( 7 tae pea ZIP CODE BIRTHDATE: MONTH NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. (/) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM —P (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS DATE maser || oe LETTER REC’D a ——— MAR. FOR CHURCH sion = pmaciae Te Y degen five. FZ. geben ADDRESS a N E AND ee ——— MAKES ( OF ODE DESIRES OF J ot or THE FOLLOWING CHRIST 5 - A? NEAREST naan SSS ) ACCEPTS RK comm PAA ee PUBLIC AS MEMBERSHIP ( ) BY LETTER FROM ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR OTHER >. THAN YEAR ABOVE AMS SAs —_——-- oe ) OTHER DECISION Ox ‘LZ ADDRESS | G hove Se ZIP CODE eee COMMITMENT: PERSONAL IN KIN PHONE THIS SAVIOUR CHURCH: AND BY FOR LORD. BAPTISM. BY STATEMENT ;| CLERK’S DATE (4) BAPTIZED DATE LETTER REC’D CHURCH RELATED VOCATION (AREAIF KNOWN) ( ) REDEDICATES LIFE TO CHRIST. ( bd DIFFERENT) 200 ADDRESS Zt MEMBERSHIP pare>- 30-41 CNT IE 393 T¢% BUSINESS ADDRESS_ BIRTHDATE: a . Code 4384-05, ACM-5, Broadman Suppiies, Nashville, Tennessee, Printed in U.S.A. ee USE ONLY - 7 7’) APPLICATION FOR CHURCH MEMBERSHIP AS | t C ey RESIDENCE EOD TH+ WISTS Wo M AS Biol . Nod Lasibon | MAILING ADDRESS (IF DIFFERENT) _ 22.0,vw -<_ BUSINESS ADDRESS BIRTHDATE: MONTH NAME AND ADDRESS OF NEAREST OF . =A MAKES THE FOLLOWING S DAY ZIP DATE — a = copp 2 YOY! puone_ 7 29-O3 Y/ ZIP CODE PHONE a ZIP CODE YEAR x & KIN OTHER THAN ABOVE ADDRESS ZIP | CODE PUBLIC COMMITMENT: (_) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED (_) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( ) BY LETTER FROM Xx d YES FOR CLERK’S USE ONLY NO ____ DATE BaPTizeo ; BY STATEMENT ; | DATE LETTER REC’D ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS 7~ L . 9 x APPLICATION FOR CHURCH MEMBERSHIP Cmis). Uy (TNEY_ RESIDENCE s 3 7X e. TimMBERS 3375 _ DATE Ho, Ca pet MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH f. me DAY 7-2 [- SORE S44 prone ZI7-9747 ZIP CODE PHONE a ee, a. ZIP CODE YEAR 7 F ©) NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS Teay LROY TimeeRS | z GEK CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ____, YES ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. X ( “4 7 DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM PO FOR CLERK’S USE ONLY scams / * DATE paptizen / ; BY STATEMENT ; | DATE t LETTER REC’D ) BY LETTER FROM ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS } ’ - U- q ¥ " mo i APPLICATION FOR CHURCH MEMBERSHIP ms MR. MISS. RESIDENCE Rocwe OCHEwe LLE / (AJAR KR PEN \ ZIP pate_ JQ - x6 - G7 CODE PHONE ZIP CODE PHONE MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH DAY YEAR NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ee BERTWA MAKES THE FOLLOWING ( ECUOTT ( ) DESIRES MEMBERSHIP ( ) BY LETTER FROM CODE ZIP PUBLIC COMMITMENT: ) ENROLL ME IN SUNDAY SCHOOL: ALREADY IN THIS CHURCH: ENROLLED BY BAPTISM _____, YES ZIP CODE FOR CLERK’S USE ONLY NO ___ DATE ; BY STATEMENT ; | DATE LETTER REC’D ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS re APPLICATION FOR CHURCH MEMBERSHIP AVPtSH RESIDENCE / LA AK A RVELAS E Kt L _, AK K Daten CODE £7- PHONE MAILING ADDRESS (IF DIFFERENT) TT4 -4000 CODE BUSINESS ADDRESS CODE i BIRTHDATE: MONTH PLL DAY [ Y PHONE YEARwh a NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ZIP CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED ___, YES ___, (_ ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( ) BY LETTER FROM FOR CLERK’S USE ONLY NO ______ DATE BAPTIZED ; BY STATEMENT ; | DATE LETTER REC’D ADDRESS OF CHURCH ( ) DEDICATES LIFE FOR CHURCH RELATED VOCATION (_ ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS .- * MR APPLICATION FOR CHURCH MEMBERSHIP ms ARoy J RESIDENCE _~ JI O IS LU aseicton Cor K D oR v\ CODE MAILING ADDRESS (IF DIFFERENT) se PHONE ZIP CODE BUSINESS ADDRESS BIRTHDATE: MONTH / O DAY / Y ZIP CODE PHONE YEAR J J NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ZIP CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED _____, YES ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ( ) BY LETTER FROM PO FOR CLERK’S USE ONLY accents DATE BAPTIZED ; BY STATEMENT Xx ; | DATE LETTER REC’D ADDRESS OF CHURCH (_ ) DEDICATES LIFE FOR CHURCH RELATED VOCATION (_ ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP MR. MRS. MISS. RESIDENCE ; | 154 Aa AL! = LA JITS PITAL MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH ( | fh) FLavras » f Lr = OCTOBER / DAY {7 DATE LO) A) (TLL) / one PT = PHONE ZIP CODE PHONE YEAR q x ZIP CODE ; ZIP CODE FOR CLERK’S USE ONLY NO ___ DATE ; BY STATEMENT ; | DATE LETTER REC’D ( ) BY LETTER FROM ADDRESS OF CHURCH (_ ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION op os __/ 7 x { MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM \ CODE NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED _____ YES : / (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS APPLICATION FOR CHURCH MEMBERSHIP MR. MRS. MISS. ke |CK RESIDENCE asa OY ar 7 =F we I O cH OP om i <7 Any. , DS Sl: IEA (2K ZIP CODE t ZIP CODE MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS “ BIRTHDATE: MONTH = DAY pare APRIL f, PHONE = - __<X 3 YEAR “? CC 4 ZIP CODE FELLOUISH Et MAKES THE FOLLOWING PUBLIC COMMITMENT: sHiP FOR CLERK’S USE ONLY (_ ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED _____ YES___ NO____ (_ ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. , (S4DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM ; BY STATEMENT K ( ) BY LETTER FROM FA TH ST ya LA 7A riisd/ 4-7 I se ok A f Enc AY ee | OKS\ DATE BAPTIZED : | pee j ADDRESS OF CHURCH (_ ) DEDICATES LIFE FOR CHURCH RELATED VOCATION ( ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (YTS _ ~ YLL YO (PHONE.3751357-5 7 / 1 ZIP CODE NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS 7 | (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS —— -5-! ¥-5-7§ APPLICATION FOR CHURCH MEMBERSHIP MR. a ISA [Af LORIGA T _ DATE APALL RESIDENCE S/O Ey ce] 75 Se ‘ MAILING ADDRESS (IF DIFFERENT) BUSINESS ADDRESS BIRTHDATE: MONTH [O NAME AND Tye pay__ Waer7vé CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: ( ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED . ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. YES ____ >» NO____ ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM xX FOR CLERK’S USE ONLY : DATE Lf. 2 l _ g y BAPTIZED - BY STATEMENT ; | DATE LETTER REC’D ( ) BY LETTER FROM ADDRESS OF CHURCH (_ ) DEDICATES LIFE FOR CHURCH RELATED VOCATION (_ ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION (99 ¥ cope LYLAS riot 2A *7T¢ES3 = CODE CODE PHONE 02 od ver (7 F/ OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS BPHNE |X, (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS —_ aes rl i The Lord is my Shepherd; I shall not want. He maketh me to lie down in green pastures; He leadeth me beside the still waters. He restorcth my soul; He leadeth me in the paths of righteousness for His name's sake. Yea, though I walk through the valley of the shadow of death, I will fear no evil; for Thou art with me; Thy rod and Thy staff they comfort me; Thou preparest a table before me in the presence of mine enemies; Thou anointest my head with oil, my cup runneth over. Surely goodness and mercy shall follow me all the days of my life; and I will dwell in the house of the Lord forever. IN MEMORY OF BEHZAD DARIAN JOOYAN February 7, 1963 DATE OF BIRTH June 11, 1999 DATE OF DEATH MEMORIAL SERVICES Tuesday, June 15, 1999 at 1:00 p.m. New Zion Baptist Church Prelude .................. Dr. Donald Carpenter “Battle Hymn Of The Republic” The New Zion Choir Scripture & Prayer .............. Rev. Cal. Carter Saxophone Solo ............... Harry Woodward “Precious Lord”’ Obituary & Resolution .... Elizabeth Ann Carpenter DPCAKETS . 2 geek ee as kad hw CHE eo ee ete we ee Representatives of Futures Through Choices, Inc. Dr. Donald Carpenter Mr. Ryan Jooyan “Amazing Grace” .........- The New Zion Choir EQUORY 2. ccc cece cota a nn Rev. Cal Carter Recessional .............. Dr. Donald Carpenter On behalf of gratitude for thought and the memorial Appreciation the family, we wish to express their your many kindnesses evidenced in deed, and for your attendance at service. Lindquist Montuaries printed in USA, ©1994 (IMPORTANT MESSAGE) e™ MI OOF PHONEFAX Lo IVI CS hoe | AREA CODE NUMBER AREA CODE NUMBER MESSAGE Vé VIDIISORD SIGNED EEA FORM >» MADE 3002S IN U.S.A. | EXTENSION FIME TO CALL APPLICATION FOR CHURCH MEMBERSHIP TER i RY L Ss UY Ch CODE RESIDENCE MAILING ADDRESS (IF DIFFERENT) PRONE ge DAY oY YEAR L 2 YES __, ( ) ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD. ( ) DESIRES MEMBERSHIP IN THIS CHURCH: BY BAPTISM Sige. ( ) BY LETTER FROM ) DEDICATES LIFE FOR CHURCH RELATED VOCATION (_ ) REDEDICATES LIFE TO CHRIST. ( ) OTHER DECISION 3¢¢ FOR CLERK’S USE ONLY NO. __ DATE BAPTIZED BY STATEMENT ——__________;_ | paTE LETTER REC’D ADDRESS OF CHURCH ( a ZIP CODE MAKES THE FOLLOWING PUBLIC COMMITMENT: ) ENROLL ME IN SUNDAY SCHOOL: ALREADY ENROLLED 73 ZIP COD L O NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS ( SS #-/ A ZIP CODE —___-_—____ PHONE BUSINESS ADDRESS BIRTHDATE: MONTH DATE : | (AREA IF KNOWN) Code 4384-05, ACM-5, BROADMAN & HOLMAN PUBLISHERS