Becoming a Member of New Life Church

Please fill out this form if you have decided to become a member of New Life Church (a local branch of the Church of the Nazarene) after participating in a membership class.

Name

First Name

Last Name

Date of Birth

YYYY

Current Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Transfer an existing membership of a different local Church of the Nazarene. Please type n/a if it is not the case.