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Join Our Church


First Name:
Middle Name:
Last Name:
Date of Birth:

Address:
City:
State:
Zip Code:

Phone Number:
E-mail Address:
Do you accept Jesus as your Lord and Savior?
Have you ever been Baptized?


Desires membership at TCCP:
Restored to Membership:
Recommit Date:

Baptismal Date:
Baptismal Place:
Baptismal done by:

*Name of current Church?
*Address of current Church:

Emergency Contacts


First Emergency Contact

First Name:
Last Name:
Relationship:

Cell Number:
Home Number:
E-mail Address:

Second Emergency Contact

First Name:
Last Name:
Relationship:

Cell Number:
Home Number:
E-mail Address:

Do you Have any Health Issues:

Please tell us what you are looking for in a Church:

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