Member Connection Form

Please fill out this form to get connected and click submit.

Contact Information

Name

*

Address

*

Phone

*

Email

*

This address will receive a confirmation email

Church Affiliation

Member of Church of Christ

*

Please select all that apply.

YES NO

Member Of Any Church?

*

Please select all that apply.

YES NO

Interested in 30-Lesson Bible Correspondence Course?

*

Please select all that apply.

YES NO

Comments or Questions?

*

Prayer Request & Follow-Up

Please check your request for prayer and/or follow-up:

*

Please select all that apply.

I want to be baptized for the remission of my sins. I want to repent of my sins and rededicate my life to Christ. I wish to speak privately with the Minister about the church for more information I (we) want to place membership with the North Shore Church of Christ congregation I want to request prayers of the Church Thank the church for prayers, cards, flowers, phone calls during my illness

Please use this space to make a specific request or to have your statement to be READ to the congregation during a scheduled service:

*

Description

Please fill out this form to get connected and click submit.

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