New Membership

New Members Ministry

New members are requested to complete the form below so we can reach out to you regarding the orientation class and your assignments.

MEMBERSHIP APPLICATION

SECTION I: General Information

Date of Birth:

Age:

Prefix:

Dr.

Mr.

Miss

Mrs.

Ms.

Full Name:

Home Address:

Address:

City:

State:

Zip:

Home Phone #:

United States+1
United Kingdom+44
Afghanistan (‫افغانستان‬‎)+93
Albania (Shqipëri)+355
Algeria (‫الجزائر‬‎)+213
American Samoa+1
Andorra+376
Angola+244
Anguilla+1
Antigua and Barbuda+1
Argentina+54
Armenia (Հայաստան)+374
Aruba+297
Ascension Island+247
Australia+61
Austria (Österreich)+43
Azerbaijan (Azərbaycan)+994
Bahamas+1
Bahrain (‫البحرين‬‎)+973
Bangladesh (বাংলাদেশ)+880
Barbados+1
Belarus (Беларусь)+375
Belgium (België)+32
Belize+501
Benin (Bénin)+229
Bermuda+1
Bhutan (འབྲུག)+975
Bolivia+591
Bosnia and Herzegovina (Босна и Херцеговина)+387
Botswana+267
Brazil (Brasil)+55
British Indian Ocean Territory+246
British Virgin Islands+1
Brunei+673
Bulgaria (България)+359
Burkina Faso+226
Burundi (Uburundi)+257
Cambodia (កម្ពុជា)+855
Cameroon (Cameroun)+237
Canada+1
Cape Verde (Kabu Verdi)+238
Caribbean Netherlands+599
Cayman Islands+1
Central African Republic (République centrafricaine)+236
Chad (Tchad)+235
Chile+56
China (中国)+86
Christmas Island+61
Cocos (Keeling) Islands+61
Colombia+57
Comoros (‫جزر القمر‬‎)+269
Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo)+243
Congo (Republic) (Congo-Brazzaville)+242
Cook Islands+682
Costa Rica+506
Côte d’Ivoire+225
Croatia (Hrvatska)+385
Cuba+53
Curaçao+599
Cyprus (Κύπρος)+357
Czech Republic (Česká republika)+420
Denmark (Danmark)+45
Djibouti+253
Dominica+1
Dominican Republic (República Dominicana)+1
Ecuador+593
Egypt (‫مصر‬‎)+20
El Salvador+503
Equatorial Guinea (Guinea Ecuatorial)+240
Eritrea+291
Estonia (Eesti)+372
Eswatini+268
Ethiopia+251
Falkland Islands (Islas Malvinas)+500
Faroe Islands (Føroyar)+298
Fiji+679
Finland (Suomi)+358
France+33
French Guiana (Guyane française)+594
French Polynesia (Polynésie française)+689
Gabon+241
Gambia+220
Georgia (საქართველო)+995
Germany (Deutschland)+49
Ghana (Gaana)+233
Gibraltar+350
Greece (Ελλάδα)+30
Greenland (Kalaallit Nunaat)+299
Grenada+1
Guadeloupe+590
Guam+1
Guatemala+502
Guernsey+44
Guinea (Guinée)+224
Guinea-Bissau (Guiné Bissau)+245
Guyana+592
Haiti+509
Honduras+504
Hong Kong (香港)+852
Hungary (Magyarország)+36
Iceland (Ísland)+354
India (भारत)+91
Indonesia+62
Iran (‫ایران‬‎)+98
Iraq (‫العراق‬‎)+964
Ireland+353
Isle of Man+44
Israel (‫ישראל‬‎)+972
Italy (Italia)+39
Jamaica+1
Japan (日本)+81
Jersey+44
Jordan (‫الأردن‬‎)+962
Kazakhstan (Казахстан)+7
Kenya+254
Kiribati+686
Kosovo+383
Kuwait (‫الكويت‬‎)+965
Kyrgyzstan (Кыргызстан)+996
Laos (ລາວ)+856
Latvia (Latvija)+371
Lebanon (‫لبنان‬‎)+961
Lesotho+266
Liberia+231
Libya (‫ليبيا‬‎)+218
Liechtenstein+423
Lithuania (Lietuva)+370
Luxembourg+352
Macau (澳門)+853
Madagascar (Madagasikara)+261
Malawi+265
Malaysia+60
Maldives+960
Mali+223
Malta+356
Marshall Islands+692
Martinique+596
Mauritania (‫موريتانيا‬‎)+222
Mauritius (Moris)+230
Mayotte+262
Mexico (México)+52
Micronesia+691
Moldova (Republica Moldova)+373
Monaco+377
Mongolia (Монгол)+976
Montenegro (Crna Gora)+382
Montserrat+1
Morocco (‫المغرب‬‎)+212
Mozambique (Moçambique)+258
Myanmar (Burma) (မြန်မာ)+95
Namibia (Namibië)+264
Nauru+674
Nepal (नेपाल)+977
Netherlands (Nederland)+31
New Caledonia (Nouvelle-Calédonie)+687
New Zealand+64
Nicaragua+505
Niger (Nijar)+227
Nigeria+234
Niue+683
Norfolk Island+672
North Korea (조선 민주주의 인민 공화국)+850
North Macedonia (Северна Македонија)+389
Northern Mariana Islands+1
Norway (Norge)+47
Oman (‫عُمان‬‎)+968
Pakistan (‫پاکستان‬‎)+92
Palau+680
Palestine (‫فلسطين‬‎)+970
Panama (Panamá)+507
Papua New Guinea+675
Paraguay+595
Peru (Perú)+51
Philippines+63
Poland (Polska)+48
Portugal+351
Puerto Rico+1
Qatar (‫قطر‬‎)+974
Réunion (La Réunion)+262
Romania (România)+40
Russia (Россия)+7
Rwanda+250
Saint Barthélemy+590
Saint Helena+290
Saint Kitts and Nevis+1
Saint Lucia+1
Saint Martin (Saint-Martin (partie française))+590
Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon)+508
Saint Vincent and the Grenadines+1
Samoa+685
San Marino+378
São Tomé and Príncipe (São Tomé e Príncipe)+239
Saudi Arabia (‫المملكة العربية السعودية‬‎)+966
Senegal (Sénégal)+221
Serbia (Србија)+381
Seychelles+248
Sierra Leone+232
Singapore+65
Sint Maarten+1
Slovakia (Slovensko)+421
Slovenia (Slovenija)+386
Solomon Islands+677
Somalia (Soomaaliya)+252
South Africa+27
South Korea (대한민국)+82
South Sudan (‫جنوب السودان‬‎)+211
Spain (España)+34
Sri Lanka (ශ්‍රී ලංකාව)+94
Sudan (‫السودان‬‎)+249
Suriname+597
Svalbard and Jan Mayen+47
Sweden (Sverige)+46
Switzerland (Schweiz)+41
Syria (‫سوريا‬‎)+963
Taiwan (台灣)+886
Tajikistan+992
Tanzania+255
Thailand (ไทย)+66
Timor-Leste+670
Togo+228
Tokelau+690
Tonga+676
Trinidad and Tobago+1
Tunisia (‫تونس‬‎)+216
Turkey (Türkiye)+90
Turkmenistan+993
Turks and Caicos Islands+1
Tuvalu+688
U.S. Virgin Islands+1
Uganda+256
Ukraine (Україна)+380
United Arab Emirates (‫الإمارات العربية المتحدة‬‎)+971
United Kingdom+44
United States+1
Uruguay+598
Uzbekistan (Oʻzbekiston)+998
Vanuatu+678
Vatican City (Città del Vaticano)+39
Venezuela+58
Vietnam (Việt Nam)+84
Wallis and Futuna (Wallis-et-Futuna)+681
Western Sahara (‫الصحراء الغربية‬‎)+212
Yemen (‫اليمن‬‎)+967
Zambia+260
Zimbabwe+263
Åland Islands+358

Work Phone #:

United States+1
United Kingdom+44
Afghanistan (‫افغانستان‬‎)+93
Albania (Shqipëri)+355
Algeria (‫الجزائر‬‎)+213
American Samoa+1
Andorra+376
Angola+244
Anguilla+1
Antigua and Barbuda+1
Argentina+54
Armenia (Հայաստան)+374
Aruba+297
Ascension Island+247
Australia+61
Austria (Österreich)+43
Azerbaijan (Azərbaycan)+994
Bahamas+1
Bahrain (‫البحرين‬‎)+973
Bangladesh (বাংলাদেশ)+880
Barbados+1
Belarus (Беларусь)+375
Belgium (België)+32
Belize+501
Benin (Bénin)+229
Bermuda+1
Bhutan (འབྲུག)+975
Bolivia+591
Bosnia and Herzegovina (Босна и Херцеговина)+387
Botswana+267
Brazil (Brasil)+55
British Indian Ocean Territory+246
British Virgin Islands+1
Brunei+673
Bulgaria (България)+359
Burkina Faso+226
Burundi (Uburundi)+257
Cambodia (កម្ពុជា)+855
Cameroon (Cameroun)+237
Canada+1
Cape Verde (Kabu Verdi)+238
Caribbean Netherlands+599
Cayman Islands+1
Central African Republic (République centrafricaine)+236
Chad (Tchad)+235
Chile+56
China (中国)+86
Christmas Island+61
Cocos (Keeling) Islands+61
Colombia+57
Comoros (‫جزر القمر‬‎)+269
Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo)+243
Congo (Republic) (Congo-Brazzaville)+242
Cook Islands+682
Costa Rica+506
Côte d’Ivoire+225
Croatia (Hrvatska)+385
Cuba+53
Curaçao+599
Cyprus (Κύπρος)+357
Czech Republic (Česká republika)+420
Denmark (Danmark)+45
Djibouti+253
Dominica+1
Dominican Republic (República Dominicana)+1
Ecuador+593
Egypt (‫مصر‬‎)+20
El Salvador+503
Equatorial Guinea (Guinea Ecuatorial)+240
Eritrea+291
Estonia (Eesti)+372
Eswatini+268
Ethiopia+251
Falkland Islands (Islas Malvinas)+500
Faroe Islands (Føroyar)+298
Fiji+679
Finland (Suomi)+358
France+33
French Guiana (Guyane française)+594
French Polynesia (Polynésie française)+689
Gabon+241
Gambia+220
Georgia (საქართველო)+995
Germany (Deutschland)+49
Ghana (Gaana)+233
Gibraltar+350
Greece (Ελλάδα)+30
Greenland (Kalaallit Nunaat)+299
Grenada+1
Guadeloupe+590
Guam+1
Guatemala+502
Guernsey+44
Guinea (Guinée)+224
Guinea-Bissau (Guiné Bissau)+245
Guyana+592
Haiti+509
Honduras+504
Hong Kong (香港)+852
Hungary (Magyarország)+36
Iceland (Ísland)+354
India (भारत)+91
Indonesia+62
Iran (‫ایران‬‎)+98
Iraq (‫العراق‬‎)+964
Ireland+353
Isle of Man+44
Israel (‫ישראל‬‎)+972
Italy (Italia)+39
Jamaica+1
Japan (日本)+81
Jersey+44
Jordan (‫الأردن‬‎)+962
Kazakhstan (Казахстан)+7
Kenya+254
Kiribati+686
Kosovo+383
Kuwait (‫الكويت‬‎)+965
Kyrgyzstan (Кыргызстан)+996
Laos (ລາວ)+856
Latvia (Latvija)+371
Lebanon (‫لبنان‬‎)+961
Lesotho+266
Liberia+231
Libya (‫ليبيا‬‎)+218
Liechtenstein+423
Lithuania (Lietuva)+370
Luxembourg+352
Macau (澳門)+853
Madagascar (Madagasikara)+261
Malawi+265
Malaysia+60
Maldives+960
Mali+223
Malta+356
Marshall Islands+692
Martinique+596
Mauritania (‫موريتانيا‬‎)+222
Mauritius (Moris)+230
Mayotte+262
Mexico (México)+52
Micronesia+691
Moldova (Republica Moldova)+373
Monaco+377
Mongolia (Монгол)+976
Montenegro (Crna Gora)+382
Montserrat+1
Morocco (‫المغرب‬‎)+212
Mozambique (Moçambique)+258
Myanmar (Burma) (မြန်မာ)+95
Namibia (Namibië)+264
Nauru+674
Nepal (नेपाल)+977
Netherlands (Nederland)+31
New Caledonia (Nouvelle-Calédonie)+687
New Zealand+64
Nicaragua+505
Niger (Nijar)+227
Nigeria+234
Niue+683
Norfolk Island+672
North Korea (조선 민주주의 인민 공화국)+850
North Macedonia (Северна Македонија)+389
Northern Mariana Islands+1
Norway (Norge)+47
Oman (‫عُمان‬‎)+968
Pakistan (‫پاکستان‬‎)+92
Palau+680
Palestine (‫فلسطين‬‎)+970
Panama (Panamá)+507
Papua New Guinea+675
Paraguay+595
Peru (Perú)+51
Philippines+63
Poland (Polska)+48
Portugal+351
Puerto Rico+1
Qatar (‫قطر‬‎)+974
Réunion (La Réunion)+262
Romania (România)+40
Russia (Россия)+7
Rwanda+250
Saint Barthélemy+590
Saint Helena+290
Saint Kitts and Nevis+1
Saint Lucia+1
Saint Martin (Saint-Martin (partie française))+590
Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon)+508
Saint Vincent and the Grenadines+1
Samoa+685
San Marino+378
São Tomé and Príncipe (São Tomé e Príncipe)+239
Saudi Arabia (‫المملكة العربية السعودية‬‎)+966
Senegal (Sénégal)+221
Serbia (Србија)+381
Seychelles+248
Sierra Leone+232
Singapore+65
Sint Maarten+1
Slovakia (Slovensko)+421
Slovenia (Slovenija)+386
Solomon Islands+677
Somalia (Soomaaliya)+252
South Africa+27
South Korea (대한민국)+82
South Sudan (‫جنوب السودان‬‎)+211
Spain (España)+34
Sri Lanka (ශ්‍රී ලංකාව)+94
Sudan (‫السودان‬‎)+249
Suriname+597
Svalbard and Jan Mayen+47
Sweden (Sverige)+46
Switzerland (Schweiz)+41
Syria (‫سوريا‬‎)+963
Taiwan (台灣)+886
Tajikistan+992
Tanzania+255
Thailand (ไทย)+66
Timor-Leste+670
Togo+228
Tokelau+690
Tonga+676
Trinidad and Tobago+1
Tunisia (‫تونس‬‎)+216
Turkey (Türkiye)+90
Turkmenistan+993
Turks and Caicos Islands+1
Tuvalu+688
U.S. Virgin Islands+1
Uganda+256
Ukraine (Україна)+380
United Arab Emirates (‫الإمارات العربية المتحدة‬‎)+971
United Kingdom+44
United States+1
Uruguay+598
Uzbekistan (Oʻzbekiston)+998
Vanuatu+678
Vatican City (Città del Vaticano)+39
Venezuela+58
Vietnam (Việt Nam)+84
Wallis and Futuna (Wallis-et-Futuna)+681
Western Sahara (‫الصحراء الغربية‬‎)+212
Yemen (‫اليمن‬‎)+967
Zambia+260
Zimbabwe+263
Åland Islands+358

Cell Phone#:

United States+1
United Kingdom+44
Afghanistan (‫افغانستان‬‎)+93
Albania (Shqipëri)+355
Algeria (‫الجزائر‬‎)+213
American Samoa+1
Andorra+376
Angola+244
Anguilla+1
Antigua and Barbuda+1
Argentina+54
Armenia (Հայաստան)+374
Aruba+297
Ascension Island+247
Australia+61
Austria (Österreich)+43
Azerbaijan (Azərbaycan)+994
Bahamas+1
Bahrain (‫البحرين‬‎)+973
Bangladesh (বাংলাদেশ)+880
Barbados+1
Belarus (Беларусь)+375
Belgium (België)+32
Belize+501
Benin (Bénin)+229
Bermuda+1
Bhutan (འབྲུག)+975
Bolivia+591
Bosnia and Herzegovina (Босна и Херцеговина)+387
Botswana+267
Brazil (Brasil)+55
British Indian Ocean Territory+246
British Virgin Islands+1
Brunei+673
Bulgaria (България)+359
Burkina Faso+226
Burundi (Uburundi)+257
Cambodia (កម្ពុជា)+855
Cameroon (Cameroun)+237
Canada+1
Cape Verde (Kabu Verdi)+238
Caribbean Netherlands+599
Cayman Islands+1
Central African Republic (République centrafricaine)+236
Chad (Tchad)+235
Chile+56
China (中国)+86
Christmas Island+61
Cocos (Keeling) Islands+61
Colombia+57
Comoros (‫جزر القمر‬‎)+269
Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo)+243
Congo (Republic) (Congo-Brazzaville)+242
Cook Islands+682
Costa Rica+506
Côte d’Ivoire+225
Croatia (Hrvatska)+385
Cuba+53
Curaçao+599
Cyprus (Κύπρος)+357
Czech Republic (Česká republika)+420
Denmark (Danmark)+45
Djibouti+253
Dominica+1
Dominican Republic (República Dominicana)+1
Ecuador+593
Egypt (‫مصر‬‎)+20
El Salvador+503
Equatorial Guinea (Guinea Ecuatorial)+240
Eritrea+291
Estonia (Eesti)+372
Eswatini+268
Ethiopia+251
Falkland Islands (Islas Malvinas)+500
Faroe Islands (Føroyar)+298
Fiji+679
Finland (Suomi)+358
France+33
French Guiana (Guyane française)+594
French Polynesia (Polynésie française)+689
Gabon+241
Gambia+220
Georgia (საქართველო)+995
Germany (Deutschland)+49
Ghana (Gaana)+233
Gibraltar+350
Greece (Ελλάδα)+30
Greenland (Kalaallit Nunaat)+299
Grenada+1
Guadeloupe+590
Guam+1
Guatemala+502
Guernsey+44
Guinea (Guinée)+224
Guinea-Bissau (Guiné Bissau)+245
Guyana+592
Haiti+509
Honduras+504
Hong Kong (香港)+852
Hungary (Magyarország)+36
Iceland (Ísland)+354
India (भारत)+91
Indonesia+62
Iran (‫ایران‬‎)+98
Iraq (‫العراق‬‎)+964
Ireland+353
Isle of Man+44
Israel (‫ישראל‬‎)+972
Italy (Italia)+39
Jamaica+1
Japan (日本)+81
Jersey+44
Jordan (‫الأردن‬‎)+962
Kazakhstan (Казахстан)+7
Kenya+254
Kiribati+686
Kosovo+383
Kuwait (‫الكويت‬‎)+965
Kyrgyzstan (Кыргызстан)+996
Laos (ລາວ)+856
Latvia (Latvija)+371
Lebanon (‫لبنان‬‎)+961
Lesotho+266
Liberia+231
Libya (‫ليبيا‬‎)+218
Liechtenstein+423
Lithuania (Lietuva)+370
Luxembourg+352
Macau (澳門)+853
Madagascar (Madagasikara)+261
Malawi+265
Malaysia+60
Maldives+960
Mali+223
Malta+356
Marshall Islands+692
Martinique+596
Mauritania (‫موريتانيا‬‎)+222
Mauritius (Moris)+230
Mayotte+262
Mexico (México)+52
Micronesia+691
Moldova (Republica Moldova)+373
Monaco+377
Mongolia (Монгол)+976
Montenegro (Crna Gora)+382
Montserrat+1
Morocco (‫المغرب‬‎)+212
Mozambique (Moçambique)+258
Myanmar (Burma) (မြန်မာ)+95
Namibia (Namibië)+264
Nauru+674
Nepal (नेपाल)+977
Netherlands (Nederland)+31
New Caledonia (Nouvelle-Calédonie)+687
New Zealand+64
Nicaragua+505
Niger (Nijar)+227
Nigeria+234
Niue+683
Norfolk Island+672
North Korea (조선 민주주의 인민 공화국)+850
North Macedonia (Северна Македонија)+389
Northern Mariana Islands+1
Norway (Norge)+47
Oman (‫عُمان‬‎)+968
Pakistan (‫پاکستان‬‎)+92
Palau+680
Palestine (‫فلسطين‬‎)+970
Panama (Panamá)+507
Papua New Guinea+675
Paraguay+595
Peru (Perú)+51
Philippines+63
Poland (Polska)+48
Portugal+351
Puerto Rico+1
Qatar (‫قطر‬‎)+974
Réunion (La Réunion)+262
Romania (România)+40
Russia (Россия)+7
Rwanda+250
Saint Barthélemy+590
Saint Helena+290
Saint Kitts and Nevis+1
Saint Lucia+1
Saint Martin (Saint-Martin (partie française))+590
Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon)+508
Saint Vincent and the Grenadines+1
Samoa+685
San Marino+378
São Tomé and Príncipe (São Tomé e Príncipe)+239
Saudi Arabia (‫المملكة العربية السعودية‬‎)+966
Senegal (Sénégal)+221
Serbia (Србија)+381
Seychelles+248
Sierra Leone+232
Singapore+65
Sint Maarten+1
Slovakia (Slovensko)+421
Slovenia (Slovenija)+386
Solomon Islands+677
Somalia (Soomaaliya)+252
South Africa+27
South Korea (대한민국)+82
South Sudan (‫جنوب السودان‬‎)+211
Spain (España)+34
Sri Lanka (ශ්‍රී ලංකාව)+94
Sudan (‫السودان‬‎)+249
Suriname+597
Svalbard and Jan Mayen+47
Sweden (Sverige)+46
Switzerland (Schweiz)+41
Syria (‫سوريا‬‎)+963
Taiwan (台灣)+886
Tajikistan+992
Tanzania+255
Thailand (ไทย)+66
Timor-Leste+670
Togo+228
Tokelau+690
Tonga+676
Trinidad and Tobago+1
Tunisia (‫تونس‬‎)+216
Turkey (Türkiye)+90
Turkmenistan+993
Turks and Caicos Islands+1
Tuvalu+688
U.S. Virgin Islands+1
Uganda+256
Ukraine (Україна)+380
United Arab Emirates (‫الإمارات العربية المتحدة‬‎)+971
United Kingdom+44
United States+1
Uruguay+598
Uzbekistan (Oʻzbekiston)+998
Vanuatu+678
Vatican City (Città del Vaticano)+39
Venezuela+58
Vietnam (Việt Nam)+84
Wallis and Futuna (Wallis-et-Futuna)+681
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Yemen (‫اليمن‬‎)+967
Zambia+260
Zimbabwe+263
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Email Address:

Permission to contact you via telephone?

Yes

Permission to contact you via email?

Yes

Marital Status:

Married

Single

Divorced

Separated

Widowed

Date of Marriage:

Did your spouse join today?

Yes

Spouse’s D.O.B.:

Spouse’s Name:

Email Address:

Work Phone#:

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United Kingdom+44
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Azerbaijan (Azərbaycan)+994
Bahamas+1
Bahrain (‫البحرين‬‎)+973
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British Indian Ocean Territory+246
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Caribbean Netherlands+599
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Chile+56
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Colombia+57
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El Salvador+503
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Ethiopia+251
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Gambia+220
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Lesotho+266
Liberia+231
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Malta+356
Marshall Islands+692
Martinique+596
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Mayotte+262
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Monaco+377
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Nicaragua+505
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Nigeria+234
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Northern Mariana Islands+1
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Oman (‫عُمان‬‎)+968
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Palau+680
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Panama (Panamá)+507
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Philippines+63
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Romania (România)+40
Russia (Россия)+7
Rwanda+250
Saint Barthélemy+590
Saint Helena+290
Saint Kitts and Nevis+1
Saint Lucia+1
Saint Martin (Saint-Martin (partie française))+590
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Saint Vincent and the Grenadines+1
Samoa+685
San Marino+378
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Slovenia (Slovenija)+386
Solomon Islands+677
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Sudan (‫السودان‬‎)+249
Suriname+597
Svalbard and Jan Mayen+47
Sweden (Sverige)+46
Switzerland (Schweiz)+41
Syria (‫سوريا‬‎)+963
Taiwan (台灣)+886
Tajikistan+992
Tanzania+255
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Timor-Leste+670
Togo+228
Tokelau+690
Tonga+676
Trinidad and Tobago+1
Tunisia (‫تونس‬‎)+216
Turkey (Türkiye)+90
Turkmenistan+993
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United Arab Emirates (‫الإمارات العربية المتحدة‬‎)+971
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United States+1
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Vanuatu+678
Vatican City (Città del Vaticano)+39
Venezuela+58
Vietnam (Việt Nam)+84
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Western Sahara (‫الصحراء الغربية‬‎)+212
Yemen (‫اليمن‬‎)+967
Zambia+260
Zimbabwe+263
Åland Islands+358

Cell Phone#:

United States+1
United Kingdom+44
Afghanistan (‫افغانستان‬‎)+93
Albania (Shqipëri)+355
Algeria (‫الجزائر‬‎)+213
American Samoa+1
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Angola+244
Anguilla+1
Antigua and Barbuda+1
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Armenia (Հայաստան)+374
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Australia+61
Austria (Österreich)+43
Azerbaijan (Azərbaycan)+994
Bahamas+1
Bahrain (‫البحرين‬‎)+973
Bangladesh (বাংলাদেশ)+880
Barbados+1
Belarus (Беларусь)+375
Belgium (België)+32
Belize+501
Benin (Bénin)+229
Bermuda+1
Bhutan (འབྲུག)+975
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Botswana+267
Brazil (Brasil)+55
British Indian Ocean Territory+246
British Virgin Islands+1
Brunei+673
Bulgaria (България)+359
Burkina Faso+226
Burundi (Uburundi)+257
Cambodia (កម្ពុជា)+855
Cameroon (Cameroun)+237
Canada+1
Cape Verde (Kabu Verdi)+238
Caribbean Netherlands+599
Cayman Islands+1
Central African Republic (République centrafricaine)+236
Chad (Tchad)+235
Chile+56
China (中国)+86
Christmas Island+61
Cocos (Keeling) Islands+61
Colombia+57
Comoros (‫جزر القمر‬‎)+269
Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo)+243
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Cook Islands+682
Costa Rica+506
Côte d’Ivoire+225
Croatia (Hrvatska)+385
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Curaçao+599
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Denmark (Danmark)+45
Djibouti+253
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Dominican Republic (República Dominicana)+1
Ecuador+593
Egypt (‫مصر‬‎)+20
El Salvador+503
Equatorial Guinea (Guinea Ecuatorial)+240
Eritrea+291
Estonia (Eesti)+372
Eswatini+268
Ethiopia+251
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Faroe Islands (Føroyar)+298
Fiji+679
Finland (Suomi)+358
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French Polynesia (Polynésie française)+689
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Gambia+220
Georgia (საქართველო)+995
Germany (Deutschland)+49
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Gibraltar+350
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Greenland (Kalaallit Nunaat)+299
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Israel (‫ישראל‬‎)+972
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Kenya+254
Kiribati+686
Kosovo+383
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Kyrgyzstan (Кыргызстан)+996
Laos (ລາວ)+856
Latvia (Latvija)+371
Lebanon (‫لبنان‬‎)+961
Lesotho+266
Liberia+231
Libya (‫ليبيا‬‎)+218
Liechtenstein+423
Lithuania (Lietuva)+370
Luxembourg+352
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Madagascar (Madagasikara)+261
Malawi+265
Malaysia+60
Maldives+960
Mali+223
Malta+356
Marshall Islands+692
Martinique+596
Mauritania (‫موريتانيا‬‎)+222
Mauritius (Moris)+230
Mayotte+262
Mexico (México)+52
Micronesia+691
Moldova (Republica Moldova)+373
Monaco+377
Mongolia (Монгол)+976
Montenegro (Crna Gora)+382
Montserrat+1
Morocco (‫المغرب‬‎)+212
Mozambique (Moçambique)+258
Myanmar (Burma) (မြန်မာ)+95
Namibia (Namibië)+264
Nauru+674
Nepal (नेपाल)+977
Netherlands (Nederland)+31
New Caledonia (Nouvelle-Calédonie)+687
New Zealand+64
Nicaragua+505
Niger (Nijar)+227
Nigeria+234
Niue+683
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North Korea (조선 민주주의 인민 공화국)+850
North Macedonia (Северна Македонија)+389
Northern Mariana Islands+1
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Oman (‫عُمان‬‎)+968
Pakistan (‫پاکستان‬‎)+92
Palau+680
Palestine (‫فلسطين‬‎)+970
Panama (Panamá)+507
Papua New Guinea+675
Paraguay+595
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Philippines+63
Poland (Polska)+48
Portugal+351
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Qatar (‫قطر‬‎)+974
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Romania (România)+40
Russia (Россия)+7
Rwanda+250
Saint Barthélemy+590
Saint Helena+290
Saint Kitts and Nevis+1
Saint Lucia+1
Saint Martin (Saint-Martin (partie française))+590
Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon)+508
Saint Vincent and the Grenadines+1
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Saudi Arabia (‫المملكة العربية السعودية‬‎)+966
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Serbia (Србија)+381
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Sierra Leone+232
Singapore+65
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Slovenia (Slovenija)+386
Solomon Islands+677
Somalia (Soomaaliya)+252
South Africa+27
South Korea (대한민국)+82
South Sudan (‫جنوب السودان‬‎)+211
Spain (España)+34
Sri Lanka (ශ්‍රී ලංකාව)+94
Sudan (‫السودان‬‎)+249
Suriname+597
Svalbard and Jan Mayen+47
Sweden (Sverige)+46
Switzerland (Schweiz)+41
Syria (‫سوريا‬‎)+963
Taiwan (台灣)+886
Tajikistan+992
Tanzania+255
Thailand (ไทย)+66
Timor-Leste+670
Togo+228
Tokelau+690
Tonga+676
Trinidad and Tobago+1
Tunisia (‫تونس‬‎)+216
Turkey (Türkiye)+90
Turkmenistan+993
Turks and Caicos Islands+1
Tuvalu+688
U.S. Virgin Islands+1
Uganda+256
Ukraine (Україна)+380
United Arab Emirates (‫الإمارات العربية المتحدة‬‎)+971
United Kingdom+44
United States+1
Uruguay+598
Uzbekistan (Oʻzbekiston)+998
Vanuatu+678
Vatican City (Città del Vaticano)+39
Venezuela+58
Vietnam (Việt Nam)+84
Wallis and Futuna (Wallis-et-Futuna)+681
Western Sahara (‫الصحراء الغربية‬‎)+212
Yemen (‫اليمن‬‎)+967
Zambia+260
Zimbabwe+263
Åland Islands+358

YOUR DECISION TODAY

Did you come forth to receive (please check which the box below):

SALVATION - Receive CHRIST for the 1st Time

Christian Experience / Membership to the Church

Rededication/Restoration of Your Life

Watch Care (I have membership somewhere else)

For Special Prayer

(Membership somewhere else) Where?

Special Prayer for:

If coming from another church, did you leave in “Good Standing”?

Yes

GETTING CONNECTED: You will be contacted to schedule your New Member Orientation Classes in order to begin to grow, expand and learn what we believe here at O'Kelly Missionary Baptist Church along with understanding our Vision and Mission. We are very strong on making disciples so that you are anchored in God’s Word for your life.

Do you have children?

Yes

**Children 18 and older must complete a separate Discipleship/ Membership Application Form**

SECTION II: Children’s Information (Ages 0-17)

Child #1

Name:

D.O.B.:

Age:

Gender:

Male

Female

Child’s Alternate Phone #:

United States+1
United Kingdom+44
Afghanistan (‫افغانستان‬‎)+93
Albania (Shqipëri)+355
Algeria (‫الجزائر‬‎)+213
American Samoa+1
Andorra+376
Angola+244
Anguilla+1
Antigua and Barbuda+1
Argentina+54
Armenia (Հայաստան)+374
Aruba+297
Ascension Island+247
Australia+61
Austria (Österreich)+43
Azerbaijan (Azərbaycan)+994
Bahamas+1
Bahrain (‫البحرين‬‎)+973
Bangladesh (বাংলাদেশ)+880
Barbados+1
Belarus (Беларусь)+375
Belgium (België)+32
Belize+501
Benin (Bénin)+229
Bermuda+1
Bhutan (འབྲུག)+975
Bolivia+591
Bosnia and Herzegovina (Босна и Херцеговина)+387
Botswana+267
Brazil (Brasil)+55
British Indian Ocean Territory+246
British Virgin Islands+1
Brunei+673
Bulgaria (България)+359
Burkina Faso+226
Burundi (Uburundi)+257
Cambodia (កម្ពុជា)+855
Cameroon (Cameroun)+237
Canada+1
Cape Verde (Kabu Verdi)+238
Caribbean Netherlands+599
Cayman Islands+1
Central African Republic (République centrafricaine)+236
Chad (Tchad)+235
Chile+56
China (中国)+86
Christmas Island+61
Cocos (Keeling) Islands+61
Colombia+57
Comoros (‫جزر القمر‬‎)+269
Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo)+243
Congo (Republic) (Congo-Brazzaville)+242
Cook Islands+682
Costa Rica+506
Côte d’Ivoire+225
Croatia (Hrvatska)+385
Cuba+53
Curaçao+599
Cyprus (Κύπρος)+357
Czech Republic (Česká republika)+420
Denmark (Danmark)+45
Djibouti+253
Dominica+1
Dominican Republic (República Dominicana)+1
Ecuador+593
Egypt (‫مصر‬‎)+20
El Salvador+503
Equatorial Guinea (Guinea Ecuatorial)+240
Eritrea+291
Estonia (Eesti)+372
Eswatini+268
Ethiopia+251
Falkland Islands (Islas Malvinas)+500
Faroe Islands (Føroyar)+298
Fiji+679
Finland (Suomi)+358
France+33
French Guiana (Guyane française)+594
French Polynesia (Polynésie française)+689
Gabon+241
Gambia+220
Georgia (საქართველო)+995
Germany (Deutschland)+49
Ghana (Gaana)+233
Gibraltar+350
Greece (Ελλάδα)+30
Greenland (Kalaallit Nunaat)+299
Grenada+1
Guadeloupe+590
Guam+1
Guatemala+502
Guernsey+44
Guinea (Guinée)+224
Guinea-Bissau (Guiné Bissau)+245
Guyana+592
Haiti+509
Honduras+504
Hong Kong (香港)+852
Hungary (Magyarország)+36
Iceland (Ísland)+354
India (भारत)+91
Indonesia+62
Iran (‫ایران‬‎)+98
Iraq (‫العراق‬‎)+964
Ireland+353
Isle of Man+44
Israel (‫ישראל‬‎)+972
Italy (Italia)+39
Jamaica+1
Japan (日本)+81
Jersey+44
Jordan (‫الأردن‬‎)+962
Kazakhstan (Казахстан)+7
Kenya+254
Kiribati+686
Kosovo+383
Kuwait (‫الكويت‬‎)+965
Kyrgyzstan (Кыргызстан)+996
Laos (ລາວ)+856
Latvia (Latvija)+371
Lebanon (‫لبنان‬‎)+961
Lesotho+266
Liberia+231
Libya (‫ليبيا‬‎)+218
Liechtenstein+423
Lithuania (Lietuva)+370
Luxembourg+352
Macau (澳門)+853
Madagascar (Madagasikara)+261
Malawi+265
Malaysia+60
Maldives+960
Mali+223
Malta+356
Marshall Islands+692
Martinique+596
Mauritania (‫موريتانيا‬‎)+222
Mauritius (Moris)+230
Mayotte+262
Mexico (México)+52
Micronesia+691
Moldova (Republica Moldova)+373
Monaco+377
Mongolia (Монгол)+976
Montenegro (Crna Gora)+382
Montserrat+1
Morocco (‫المغرب‬‎)+212
Mozambique (Moçambique)+258
Myanmar (Burma) (မြန်မာ)+95
Namibia (Namibië)+264
Nauru+674
Nepal (नेपाल)+977
Netherlands (Nederland)+31
New Caledonia (Nouvelle-Calédonie)+687
New Zealand+64
Nicaragua+505
Niger (Nijar)+227
Nigeria+234
Niue+683
Norfolk Island+672
North Korea (조선 민주주의 인민 공화국)+850
North Macedonia (Северна Македонија)+389
Northern Mariana Islands+1
Norway (Norge)+47
Oman (‫عُمان‬‎)+968
Pakistan (‫پاکستان‬‎)+92
Palau+680
Palestine (‫فلسطين‬‎)+970
Panama (Panamá)+507
Papua New Guinea+675
Paraguay+595
Peru (Perú)+51
Philippines+63
Poland (Polska)+48
Portugal+351
Puerto Rico+1
Qatar (‫قطر‬‎)+974
Réunion (La Réunion)+262
Romania (România)+40
Russia (Россия)+7
Rwanda+250
Saint Barthélemy+590
Saint Helena+290
Saint Kitts and Nevis+1
Saint Lucia+1
Saint Martin (Saint-Martin (partie française))+590
Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon)+508
Saint Vincent and the Grenadines+1
Samoa+685
San Marino+378
São Tomé and Príncipe (São Tomé e Príncipe)+239
Saudi Arabia (‫المملكة العربية السعودية‬‎)+966
Senegal (Sénégal)+221
Serbia (Србија)+381
Seychelles+248
Sierra Leone+232
Singapore+65
Sint Maarten+1
Slovakia (Slovensko)+421
Slovenia (Slovenija)+386
Solomon Islands+677
Somalia (Soomaaliya)+252
South Africa+27
South Korea (대한민국)+82
South Sudan (‫جنوب السودان‬‎)+211
Spain (España)+34
Sri Lanka (ශ්‍රී ලංකාව)+94
Sudan (‫السودان‬‎)+249
Suriname+597
Svalbard and Jan Mayen+47
Sweden (Sverige)+46
Switzerland (Schweiz)+41
Syria (‫سوريا‬‎)+963
Taiwan (台灣)+886
Tajikistan+992
Tanzania+255
Thailand (ไทย)+66
Timor-Leste+670
Togo+228
Tokelau+690
Tonga+676
Trinidad and Tobago+1
Tunisia (‫تونس‬‎)+216
Turkey (Türkiye)+90
Turkmenistan+993
Turks and Caicos Islands+1
Tuvalu+688
U.S. Virgin Islands+1
Uganda+256
Ukraine (Україна)+380
United Arab Emirates (‫الإمارات العربية المتحدة‬‎)+971
United Kingdom+44
United States+1
Uruguay+598
Uzbekistan (Oʻzbekiston)+998
Vanuatu+678
Vatican City (Città del Vaticano)+39
Venezuela+58
Vietnam (Việt Nam)+84
Wallis and Futuna (Wallis-et-Futuna)+681
Western Sahara (‫الصحراء الغربية‬‎)+212
Yemen (‫اليمن‬‎)+967
Zambia+260
Zimbabwe+263
Åland Islands+358

Add 2nd Child?

Yes

Child #2

Name:

D.O.B.:

Age:

Gender:

Male

Female

Child’s Alternate Phone #:

United States+1
United Kingdom+44
Afghanistan (‫افغانستان‬‎)+93
Albania (Shqipëri)+355
Algeria (‫الجزائر‬‎)+213
American Samoa+1
Andorra+376
Angola+244
Anguilla+1
Antigua and Barbuda+1
Argentina+54
Armenia (Հայաստան)+374
Aruba+297
Ascension Island+247
Australia+61
Austria (Österreich)+43
Azerbaijan (Azərbaycan)+994
Bahamas+1
Bahrain (‫البحرين‬‎)+973
Bangladesh (বাংলাদেশ)+880
Barbados+1
Belarus (Беларусь)+375
Belgium (België)+32
Belize+501
Benin (Bénin)+229
Bermuda+1
Bhutan (འབྲུག)+975
Bolivia+591
Bosnia and Herzegovina (Босна и Херцеговина)+387
Botswana+267
Brazil (Brasil)+55
British Indian Ocean Territory+246
British Virgin Islands+1
Brunei+673
Bulgaria (България)+359
Burkina Faso+226
Burundi (Uburundi)+257
Cambodia (កម្ពុជា)+855
Cameroon (Cameroun)+237
Canada+1
Cape Verde (Kabu Verdi)+238
Caribbean Netherlands+599
Cayman Islands+1
Central African Republic (République centrafricaine)+236
Chad (Tchad)+235
Chile+56
China (中国)+86
Christmas Island+61
Cocos (Keeling) Islands+61
Colombia+57
Comoros (‫جزر القمر‬‎)+269
Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo)+243
Congo (Republic) (Congo-Brazzaville)+242
Cook Islands+682
Costa Rica+506
Côte d’Ivoire+225
Croatia (Hrvatska)+385
Cuba+53
Curaçao+599
Cyprus (Κύπρος)+357
Czech Republic (Česká republika)+420
Denmark (Danmark)+45
Djibouti+253
Dominica+1
Dominican Republic (República Dominicana)+1
Ecuador+593
Egypt (‫مصر‬‎)+20
El Salvador+503
Equatorial Guinea (Guinea Ecuatorial)+240
Eritrea+291
Estonia (Eesti)+372
Eswatini+268
Ethiopia+251
Falkland Islands (Islas Malvinas)+500
Faroe Islands (Føroyar)+298
Fiji+679
Finland (Suomi)+358
France+33
French Guiana (Guyane française)+594
French Polynesia (Polynésie française)+689
Gabon+241
Gambia+220
Georgia (საქართველო)+995
Germany (Deutschland)+49
Ghana (Gaana)+233
Gibraltar+350
Greece (Ελλάδα)+30
Greenland (Kalaallit Nunaat)+299
Grenada+1
Guadeloupe+590
Guam+1
Guatemala+502
Guernsey+44
Guinea (Guinée)+224
Guinea-Bissau (Guiné Bissau)+245
Guyana+592
Haiti+509
Honduras+504
Hong Kong (香港)+852
Hungary (Magyarország)+36
Iceland (Ísland)+354
India (भारत)+91
Indonesia+62
Iran (‫ایران‬‎)+98
Iraq (‫العراق‬‎)+964
Ireland+353
Isle of Man+44
Israel (‫ישראל‬‎)+972
Italy (Italia)+39
Jamaica+1
Japan (日本)+81
Jersey+44
Jordan (‫الأردن‬‎)+962
Kazakhstan (Казахстан)+7
Kenya+254
Kiribati+686
Kosovo+383
Kuwait (‫الكويت‬‎)+965
Kyrgyzstan (Кыргызстан)+996
Laos (ລາວ)+856
Latvia (Latvija)+371
Lebanon (‫لبنان‬‎)+961
Lesotho+266
Liberia+231
Libya (‫ليبيا‬‎)+218
Liechtenstein+423
Lithuania (Lietuva)+370
Luxembourg+352
Macau (澳門)+853
Madagascar (Madagasikara)+261
Malawi+265
Malaysia+60
Maldives+960
Mali+223
Malta+356
Marshall Islands+692
Martinique+596
Mauritania (‫موريتانيا‬‎)+222
Mauritius (Moris)+230
Mayotte+262
Mexico (México)+52
Micronesia+691
Moldova (Republica Moldova)+373
Monaco+377
Mongolia (Монгол)+976
Montenegro (Crna Gora)+382
Montserrat+1
Morocco (‫المغرب‬‎)+212
Mozambique (Moçambique)+258
Myanmar (Burma) (မြန်မာ)+95
Namibia (Namibië)+264
Nauru+674
Nepal (नेपाल)+977
Netherlands (Nederland)+31
New Caledonia (Nouvelle-Calédonie)+687
New Zealand+64
Nicaragua+505
Niger (Nijar)+227
Nigeria+234
Niue+683
Norfolk Island+672
North Korea (조선 민주주의 인민 공화국)+850
North Macedonia (Северна Македонија)+389
Northern Mariana Islands+1
Norway (Norge)+47
Oman (‫عُمان‬‎)+968
Pakistan (‫پاکستان‬‎)+92
Palau+680
Palestine (‫فلسطين‬‎)+970
Panama (Panamá)+507
Papua New Guinea+675
Paraguay+595
Peru (Perú)+51
Philippines+63
Poland (Polska)+48
Portugal+351
Puerto Rico+1
Qatar (‫قطر‬‎)+974
Réunion (La Réunion)+262
Romania (România)+40
Russia (Россия)+7
Rwanda+250
Saint Barthélemy+590
Saint Helena+290
Saint Kitts and Nevis+1
Saint Lucia+1
Saint Martin (Saint-Martin (partie française))+590
Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon)+508
Saint Vincent and the Grenadines+1
Samoa+685
San Marino+378
São Tomé and Príncipe (São Tomé e Príncipe)+239
Saudi Arabia (‫المملكة العربية السعودية‬‎)+966
Senegal (Sénégal)+221
Serbia (Србија)+381
Seychelles+248
Sierra Leone+232
Singapore+65
Sint Maarten+1
Slovakia (Slovensko)+421
Slovenia (Slovenija)+386
Solomon Islands+677
Somalia (Soomaaliya)+252
South Africa+27
South Korea (대한민국)+82
South Sudan (‫جنوب السودان‬‎)+211
Spain (España)+34
Sri Lanka (ශ්‍රී ලංකාව)+94
Sudan (‫السودان‬‎)+249
Suriname+597
Svalbard and Jan Mayen+47
Sweden (Sverige)+46
Switzerland (Schweiz)+41
Syria (‫سوريا‬‎)+963
Taiwan (台灣)+886
Tajikistan+992
Tanzania+255
Thailand (ไทย)+66
Timor-Leste+670
Togo+228
Tokelau+690
Tonga+676
Trinidad and Tobago+1
Tunisia (‫تونس‬‎)+216
Turkey (Türkiye)+90
Turkmenistan+993
Turks and Caicos Islands+1
Tuvalu+688
U.S. Virgin Islands+1
Uganda+256
Ukraine (Україна)+380
United Arab Emirates (‫الإمارات العربية المتحدة‬‎)+971
United Kingdom+44
United States+1
Uruguay+598
Uzbekistan (Oʻzbekiston)+998
Vanuatu+678
Vatican City (Città del Vaticano)+39
Venezuela+58
Vietnam (Việt Nam)+84
Wallis and Futuna (Wallis-et-Futuna)+681
Western Sahara (‫الصحراء الغربية‬‎)+212
Yemen (‫اليمن‬‎)+967
Zambia+260
Zimbabwe+263
Åland Islands+358

Add 3rd Child?

Yes

Name:

D.O.B.:

Age:

Gender:

Male

Female

Child’s Alternate Phone #:

United States+1
United Kingdom+44
Afghanistan (‫افغانستان‬‎)+93
Albania (Shqipëri)+355
Algeria (‫الجزائر‬‎)+213
American Samoa+1
Andorra+376
Angola+244
Anguilla+1
Antigua and Barbuda+1
Argentina+54
Armenia (Հայաստան)+374
Aruba+297
Ascension Island+247
Australia+61
Austria (Österreich)+43
Azerbaijan (Azərbaycan)+994
Bahamas+1
Bahrain (‫البحرين‬‎)+973
Bangladesh (বাংলাদেশ)+880
Barbados+1
Belarus (Беларусь)+375
Belgium (België)+32
Belize+501
Benin (Bénin)+229
Bermuda+1
Bhutan (འབྲུག)+975
Bolivia+591
Bosnia and Herzegovina (Босна и Херцеговина)+387
Botswana+267
Brazil (Brasil)+55
British Indian Ocean Territory+246
British Virgin Islands+1
Brunei+673
Bulgaria (България)+359
Burkina Faso+226
Burundi (Uburundi)+257
Cambodia (កម្ពុជា)+855
Cameroon (Cameroun)+237
Canada+1
Cape Verde (Kabu Verdi)+238
Caribbean Netherlands+599
Cayman Islands+1
Central African Republic (République centrafricaine)+236
Chad (Tchad)+235
Chile+56
China (中国)+86
Christmas Island+61
Cocos (Keeling) Islands+61
Colombia+57
Comoros (‫جزر القمر‬‎)+269
Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo)+243
Congo (Republic) (Congo-Brazzaville)+242
Cook Islands+682
Costa Rica+506
Côte d’Ivoire+225
Croatia (Hrvatska)+385
Cuba+53
Curaçao+599
Cyprus (Κύπρος)+357
Czech Republic (Česká republika)+420
Denmark (Danmark)+45
Djibouti+253
Dominica+1
Dominican Republic (República Dominicana)+1
Ecuador+593
Egypt (‫مصر‬‎)+20
El Salvador+503
Equatorial Guinea (Guinea Ecuatorial)+240
Eritrea+291
Estonia (Eesti)+372
Eswatini+268
Ethiopia+251
Falkland Islands (Islas Malvinas)+500
Faroe Islands (Føroyar)+298
Fiji+679
Finland (Suomi)+358
France+33
French Guiana (Guyane française)+594
French Polynesia (Polynésie française)+689
Gabon+241
Gambia+220
Georgia (საქართველო)+995
Germany (Deutschland)+49
Ghana (Gaana)+233
Gibraltar+350
Greece (Ελλάδα)+30
Greenland (Kalaallit Nunaat)+299
Grenada+1
Guadeloupe+590
Guam+1
Guatemala+502
Guernsey+44
Guinea (Guinée)+224
Guinea-Bissau (Guiné Bissau)+245
Guyana+592
Haiti+509
Honduras+504
Hong Kong (香港)+852
Hungary (Magyarország)+36
Iceland (Ísland)+354
India (भारत)+91
Indonesia+62
Iran (‫ایران‬‎)+98
Iraq (‫العراق‬‎)+964
Ireland+353
Isle of Man+44
Israel (‫ישראל‬‎)+972
Italy (Italia)+39
Jamaica+1
Japan (日本)+81
Jersey+44
Jordan (‫الأردن‬‎)+962
Kazakhstan (Казахстан)+7
Kenya+254
Kiribati+686
Kosovo+383
Kuwait (‫الكويت‬‎)+965
Kyrgyzstan (Кыргызстан)+996
Laos (ລາວ)+856
Latvia (Latvija)+371
Lebanon (‫لبنان‬‎)+961
Lesotho+266
Liberia+231
Libya (‫ليبيا‬‎)+218
Liechtenstein+423
Lithuania (Lietuva)+370
Luxembourg+352
Macau (澳門)+853
Madagascar (Madagasikara)+261
Malawi+265
Malaysia+60
Maldives+960
Mali+223
Malta+356
Marshall Islands+692
Martinique+596
Mauritania (‫موريتانيا‬‎)+222
Mauritius (Moris)+230
Mayotte+262
Mexico (México)+52
Micronesia+691
Moldova (Republica Moldova)+373
Monaco+377
Mongolia (Монгол)+976
Montenegro (Crna Gora)+382
Montserrat+1
Morocco (‫المغرب‬‎)+212
Mozambique (Moçambique)+258
Myanmar (Burma) (မြန်မာ)+95
Namibia (Namibië)+264
Nauru+674
Nepal (नेपाल)+977
Netherlands (Nederland)+31
New Caledonia (Nouvelle-Calédonie)+687
New Zealand+64
Nicaragua+505
Niger (Nijar)+227
Nigeria+234
Niue+683
Norfolk Island+672
North Korea (조선 민주주의 인민 공화국)+850
North Macedonia (Северна Македонија)+389
Northern Mariana Islands+1
Norway (Norge)+47
Oman (‫عُمان‬‎)+968
Pakistan (‫پاکستان‬‎)+92
Palau+680
Palestine (‫فلسطين‬‎)+970
Panama (Panamá)+507
Papua New Guinea+675
Paraguay+595
Peru (Perú)+51
Philippines+63
Poland (Polska)+48
Portugal+351
Puerto Rico+1
Qatar (‫قطر‬‎)+974
Réunion (La Réunion)+262
Romania (România)+40
Russia (Россия)+7
Rwanda+250
Saint Barthélemy+590
Saint Helena+290
Saint Kitts and Nevis+1
Saint Lucia+1
Saint Martin (Saint-Martin (partie française))+590
Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon)+508
Saint Vincent and the Grenadines+1
Samoa+685
San Marino+378
São Tomé and Príncipe (São Tomé e Príncipe)+239
Saudi Arabia (‫المملكة العربية السعودية‬‎)+966
Senegal (Sénégal)+221
Serbia (Србија)+381
Seychelles+248
Sierra Leone+232
Singapore+65
Sint Maarten+1
Slovakia (Slovensko)+421
Slovenia (Slovenija)+386
Solomon Islands+677
Somalia (Soomaaliya)+252
South Africa+27
South Korea (대한민국)+82
South Sudan (‫جنوب السودان‬‎)+211
Spain (España)+34
Sri Lanka (ශ්‍රී ලංකාව)+94
Sudan (‫السودان‬‎)+249
Suriname+597
Svalbard and Jan Mayen+47
Sweden (Sverige)+46
Switzerland (Schweiz)+41
Syria (‫سوريا‬‎)+963
Taiwan (台灣)+886
Tajikistan+992
Tanzania+255
Thailand (ไทย)+66
Timor-Leste+670
Togo+228
Tokelau+690
Tonga+676
Trinidad and Tobago+1
Tunisia (‫تونس‬‎)+216
Turkey (Türkiye)+90
Turkmenistan+993
Turks and Caicos Islands+1
Tuvalu+688
U.S. Virgin Islands+1
Uganda+256
Ukraine (Україна)+380
United Arab Emirates (‫الإمارات العربية المتحدة‬‎)+971
United Kingdom+44
United States+1
Uruguay+598
Uzbekistan (Oʻzbekiston)+998
Vanuatu+678
Vatican City (Città del Vaticano)+39
Venezuela+58
Vietnam (Việt Nam)+84
Wallis and Futuna (Wallis-et-Futuna)+681
Western Sahara (‫الصحراء الغربية‬‎)+212
Yemen (‫اليمن‬‎)+967
Zambia+260
Zimbabwe+263
Åland Islands+358

Add 4th Child?

Yes

Name:

D.O.B.:

Age:

Gender:

Male

Female

Child’s Alternate Phone #:

United States+1
United Kingdom+44
Afghanistan (‫افغانستان‬‎)+93
Albania (Shqipëri)+355
Algeria (‫الجزائر‬‎)+213
American Samoa+1
Andorra+376
Angola+244
Anguilla+1
Antigua and Barbuda+1
Argentina+54
Armenia (Հայաստան)+374
Aruba+297
Ascension Island+247
Australia+61
Austria (Österreich)+43
Azerbaijan (Azərbaycan)+994
Bahamas+1
Bahrain (‫البحرين‬‎)+973
Bangladesh (বাংলাদেশ)+880
Barbados+1
Belarus (Беларусь)+375
Belgium (België)+32
Belize+501
Benin (Bénin)+229
Bermuda+1
Bhutan (འབྲུག)+975
Bolivia+591
Bosnia and Herzegovina (Босна и Херцеговина)+387
Botswana+267
Brazil (Brasil)+55
British Indian Ocean Territory+246
British Virgin Islands+1
Brunei+673
Bulgaria (България)+359
Burkina Faso+226
Burundi (Uburundi)+257
Cambodia (កម្ពុជា)+855
Cameroon (Cameroun)+237
Canada+1
Cape Verde (Kabu Verdi)+238
Caribbean Netherlands+599
Cayman Islands+1
Central African Republic (République centrafricaine)+236
Chad (Tchad)+235
Chile+56
China (中国)+86
Christmas Island+61
Cocos (Keeling) Islands+61
Colombia+57
Comoros (‫جزر القمر‬‎)+269
Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo)+243
Congo (Republic) (Congo-Brazzaville)+242
Cook Islands+682
Costa Rica+506
Côte d’Ivoire+225
Croatia (Hrvatska)+385
Cuba+53
Curaçao+599
Cyprus (Κύπρος)+357
Czech Republic (Česká republika)+420
Denmark (Danmark)+45
Djibouti+253
Dominica+1
Dominican Republic (República Dominicana)+1
Ecuador+593
Egypt (‫مصر‬‎)+20
El Salvador+503
Equatorial Guinea (Guinea Ecuatorial)+240
Eritrea+291
Estonia (Eesti)+372
Eswatini+268
Ethiopia+251
Falkland Islands (Islas Malvinas)+500
Faroe Islands (Føroyar)+298
Fiji+679
Finland (Suomi)+358
France+33
French Guiana (Guyane française)+594
French Polynesia (Polynésie française)+689
Gabon+241
Gambia+220
Georgia (საქართველო)+995
Germany (Deutschland)+49
Ghana (Gaana)+233
Gibraltar+350
Greece (Ελλάδα)+30
Greenland (Kalaallit Nunaat)+299
Grenada+1
Guadeloupe+590
Guam+1
Guatemala+502
Guernsey+44
Guinea (Guinée)+224
Guinea-Bissau (Guiné Bissau)+245
Guyana+592
Haiti+509
Honduras+504
Hong Kong (香港)+852
Hungary (Magyarország)+36
Iceland (Ísland)+354
India (भारत)+91
Indonesia+62
Iran (‫ایران‬‎)+98
Iraq (‫العراق‬‎)+964
Ireland+353
Isle of Man+44
Israel (‫ישראל‬‎)+972
Italy (Italia)+39
Jamaica+1
Japan (日本)+81
Jersey+44
Jordan (‫الأردن‬‎)+962
Kazakhstan (Казахстан)+7
Kenya+254
Kiribati+686
Kosovo+383
Kuwait (‫الكويت‬‎)+965
Kyrgyzstan (Кыргызстан)+996
Laos (ລາວ)+856
Latvia (Latvija)+371
Lebanon (‫لبنان‬‎)+961
Lesotho+266
Liberia+231
Libya (‫ليبيا‬‎)+218
Liechtenstein+423
Lithuania (Lietuva)+370
Luxembourg+352
Macau (澳門)+853
Madagascar (Madagasikara)+261
Malawi+265
Malaysia+60
Maldives+960
Mali+223
Malta+356
Marshall Islands+692
Martinique+596
Mauritania (‫موريتانيا‬‎)+222
Mauritius (Moris)+230
Mayotte+262
Mexico (México)+52
Micronesia+691
Moldova (Republica Moldova)+373
Monaco+377
Mongolia (Монгол)+976
Montenegro (Crna Gora)+382
Montserrat+1
Morocco (‫المغرب‬‎)+212
Mozambique (Moçambique)+258
Myanmar (Burma) (မြန်မာ)+95
Namibia (Namibië)+264
Nauru+674
Nepal (नेपाल)+977
Netherlands (Nederland)+31
New Caledonia (Nouvelle-Calédonie)+687
New Zealand+64
Nicaragua+505
Niger (Nijar)+227
Nigeria+234
Niue+683
Norfolk Island+672
North Korea (조선 민주주의 인민 공화국)+850
North Macedonia (Северна Македонија)+389
Northern Mariana Islands+1
Norway (Norge)+47
Oman (‫عُمان‬‎)+968
Pakistan (‫پاکستان‬‎)+92
Palau+680
Palestine (‫فلسطين‬‎)+970
Panama (Panamá)+507
Papua New Guinea+675
Paraguay+595
Peru (Perú)+51
Philippines+63
Poland (Polska)+48
Portugal+351
Puerto Rico+1
Qatar (‫قطر‬‎)+974
Réunion (La Réunion)+262
Romania (România)+40
Russia (Россия)+7
Rwanda+250
Saint Barthélemy+590
Saint Helena+290
Saint Kitts and Nevis+1
Saint Lucia+1
Saint Martin (Saint-Martin (partie française))+590
Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon)+508
Saint Vincent and the Grenadines+1
Samoa+685
San Marino+378
São Tomé and Príncipe (São Tomé e Príncipe)+239
Saudi Arabia (‫المملكة العربية السعودية‬‎)+966
Senegal (Sénégal)+221
Serbia (Србија)+381
Seychelles+248
Sierra Leone+232
Singapore+65
Sint Maarten+1
Slovakia (Slovensko)+421
Slovenia (Slovenija)+386
Solomon Islands+677
Somalia (Soomaaliya)+252
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Western Sahara (‫الصحراء الغربية‬‎)+212
Yemen (‫اليمن‬‎)+967
Zambia+260
Zimbabwe+263
Åland Islands+358

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Sunday School	9:45 – 10:25 AM
Worship Service Sunday	11 a.m. EST
Communion	1st Sunday
Youth Sunday	2nd Sunday
Children’s Church	1st 3rd and 4th Sunday during worship service