Saturday May 11th, 1pm
NEP Gymnasium
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Age Range
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12-25 yrs old
26+ yrs old
Which events are you interested in? (Select all that apply)
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Basketball (horse)
Soccer (Penalty kicks w/goalie)
Checkers
Bible Trivia
Jenga
Ping Pong
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Pool
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Connect 4
Cornhole
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CHECK REQUEST FORM
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Department Information
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Amount Requested
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Memo
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No payments can be disbursed without proper invoices, receipts or authorization for reimbursements. (Please attach invoices or receipts to this request)
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Birth & Dedication Application
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Zip Code
Email
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Phone
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Dates Desired 1 (4th Sundays Only)
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Dates Desired 2 (4th Sundays Only)
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Please check appropriate response:
Member
Yes
No
Related to a member
Yes
No
Member's Name
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Child's Information
Child's Name as it appears on Birth Certificate (Please provide us with a copy)
Place of Birth
Child's Gender
Hospital
Date of Birth
Parent's Name
Godparent's Name
Upload Birth Certificate
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IF YOU ARE NOT A MEMBER OR A RELATIVE OF A MEMBER HERE AT THE NEW ENGLAND PENTACOSTAL MINISTRIES, THEN THERE IS A PROCESS FEE OF $35.00.
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New England Pentecostal Ministries Membership Request Application
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Arkansas
California
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Connecticut
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Florida
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Hawaii
Idaho
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Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
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New Mexico
New York
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Zip Code
Tele/Cell (public)
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Names of Children
Email
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Birthday
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Next
Did you hold a membership at a previous church?
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If Yes
Name of Previous Pastor
Church Name
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Church Address
Telephone
Are you saved?
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Have you been baptized in the Holy Spirit?
Yes
No
Have you been water baptized?
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Are you
Married
Divorced
Separated
Single
Have you been called to the ministry?
Yes
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If so, what is your calling?
*
Were you working in the ministry prior to coming here?
Yes
No
Do you desire to work in this ministry?
Yes
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If so, in what capacity?
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Date of class to attend
Signature
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Date
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Baptism Sign Up
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Date
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I baptize you with water to show that your hearts and lives have changed" Matthew 3:11
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