New Membership Card-Online

Membership Card for The Lighthouse Church

Date Joined

Name

Relationship Status

Single Engaged Married Divorced Seperated

Spouse a member?

Yes No N/A

Spouse Name (Enter if they are joining with you now)

Address

Phone

Home Phone

This address will receive a confirmation email

Birthdate

Gender

Female Male

Please Select a Church Status

Church Status

Member (Interested in joining Lighthouse Church) Watcher Only (Not interested in joining Lighthouse Church)

Please Select a Lighthouse Church Campus

Select Campus

LH Online Only (Out of State) LH Online Only (Local: Not able to attend a Campus) LH North (Humble)- 6650 Rankin Rd. 77396 LH South - 12204 Sharpview Dr.. 77072 LH Southeast - 10800 Scott St. 77047 LH West (Katy) - 16219 Clay Rd. 77084

Salvation Yes-Ready to get to know him No-I met and know him

Baptism Yes- I would like to be baptized Yes- I would like to be re-baptized

Prayer Request (Please write below)

Child #1 Information

Child's Name

Gender

Birthdate

I would like my child to be a candidate for (you can select both) Baptism Christening

Child #2 Information

Child's Name

Birthdate

Gender

I would like my child to be a candidate for.. (you can select both) Baptism Christening

Child #3 Information

Child's Name

Gender

Birthdate

I would like my child to be a candidate for.. (you can select both) Baptism Christening

Child #4 Information

Child's Name

Gender

Birthdate

Please Do Not Write Below. Lighthouse Connector Staff Only

LH Connector Contact Date

Lighthouse Connector

Notes/Remarks

No longer interested in membership Yes

New Membership Card-Online

Description

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