Become A Member Bethel Membership Information Form Interested in becoming a member? Start by completing this form and we'll be in touch with the next steps. Step 1 of 3 33% Household InformationHead of Household Name(Required) First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Email(Required) Occupation Employer Previous Church Membership Location(s)If you haven't been a member anywhere in the past, please put NA. Date of Birth MM slash DD slash YYYY Have you been baptized? Yes No Date of Baptism MM slash DD slash YYYY Church where you were baptized: Have you been confirmed? Yes No Date of Confirmation MM slash DD slash YYYY Location of Your Confirmation: I am: Single Married Divorced Separated Widowed Date Married MM slash DD slash YYYY Location of Wedding Spouse's InformationLeave blank if not applicableName First Last Email PhoneOccupation Employer Work PhonePrevious Church Membership Location(s)If you haven't been a member anywhere in the past, please put NA. Date of Birth MM slash DD slash YYYY Have you been baptized? Yes No Date of Baptism MM slash DD slash YYYY Church where you were baptized: Have you been confirmed? Yes No Date of Confirmation MM slash DD slash YYYY Location of Your Confirmation: Children's InformationDo you have children? Yes No We are currently expecting. Due Date Add Your Children Name Grade Level Actions Edit Delete There are no Children. Add Child Maximum number of children reached. Does everything look correct?{all_fields}Verify You're A Human