LHNation Campus New Membership Card

Please fill out this form and click submit New Members Form

LH-Online Membership Card for The Lighthouse Church

Date Joined

*

Name

*

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

Address

*

Phone

*

Home Phone

Email

*

This address will receive a confirmation email

Birthdate

*

Relationship Status

*

Please select one option.

Single Engaged Married Divorced Seperated

Gender

*

Please select one option.

Female Male

Church Status

*

Please select one option.

Member Regularly Attend-Not a Member InActive-No longer Member

Select Campus

*

Please select one option.

LH Online (Only) LH North (Humble) LH South LH Southeast LH West (Katy)

1st Time to Salvation

Please select all that apply.

Yes No

Candidate for Baptism

*

Please select all that apply.

Yes No Did not select

Spouse already a member.

*

Please select all that apply.

Yes No Did not select

Child 1 Information

Child's Name

Gender

*

Please select one option.

Female Male

Birthdate

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

Please select all that apply.

Baptism Christening

Child 2 Information

Child's Name

Gender

*

Please select one option.

Female Male

Birthdate

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

Please select all that apply.

Baptism Christening

Child 3 Information

Child's Name

Gender

*

Please select one option.

Female Male

Birthdate

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

Please select all that apply.

Baptism Christening

Child 4 Information

Child's Name

Gender

*

Please select one option.

Female Male

Birthdate

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

Please select all that apply.

Baptism Christening

This section is for Lighthouse Staff Only

LH Connector Contact Date

*

Lighthouse Connector

Notes/Remarks

Member #

Description

Please fill out this form and click submit New Members Form

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