Church Membership Form | In His Presence Deliverance Ministry West Palm Beach

Name (Required)

Email Address (Required)

Your Address

Your Phone Number

Birthday

Marital Status

Emergency Contact

In the event of an emergency, who do we contact? Phone number?

What is your T-Shirt Size?

Small

Medium

Large

Extra Large

Children

Child 1. Name

Child 2. Name

Child 3. Name

Child 4. Name

Previous Church Details

Please give name and address of previous church, if applicable, for reference purpose

Church Name & Pastor's Name

Church Address

Church Phone Number

What are you interested in doing in this Ministry?

Solve 5 + 9 = ?

In His Presence Deliverance Ministry West Palm Beach