MEMBER REGISTRATION

RETURN TO THE HOME PAGE
About the SafeHouse
Happenings at the SafeHouse
About the Bishop
About the 1st Lady
Minstry Team
Prayer Request
Audio Messages
YA STOR (Young Adult Straight Talk on the Real)
Member Registration
Contact Us
Links

Your phone number and/or email address will only be used by the Ministry to contact you about ministry opportunities, special events, or announcements.  This information will NOT be shared with any other person or organization.
Please Provide The Following Information
 * REQUIRED FIELDS
General Information
Name*
 		 Address*
 
City*
 		 State*
  		 Zip*
 
Home Phone*
 		 Cell Phone
 
Email
 Date Of Birth
Emergency Contact Information
Name*
 		 Relationship To You*
 
Phone*
 		  
Family Information
Marital Status
 Spouse's Name
 
Children Under 18 In the Home?
If Yes... Names and Ages
  
Individuals 18+ In the Home?
If Yes... Names and Ages
  
Place Of Employment
 		  
Shift
 		 Phone
 
Additional Comments

 
Lookup a word or passage in the Bible



BibleGateway.com
Include this form on your page

 

 

 

 

 

 

 

 

 

 

 

 
   
 

© 2008 Faith Christian Church (The SafeHouse).  All Rights Reserved