Statement of Decision Membership Form – The Church at Clarendon

Name *

First

Last

Email *

Phone Number

Address

Birthday

Anniversary Date (if applicable)

I would like to be added to the weekly church e-newsletter

I am making a public profession of faith in Jesus Christ. I request to be baptized by immersion.

Yes
No
I would like to learn more.

I have made a profession of faith in Jesus Christ and been baptized by immersion. I request that my Membership be transferred to this church by letter from (provide Church name, Pastor and address):

If you did not select one of the previous options, please indicate the best option from the choices list below:

I come on my Statement of Christian experience and prior baptism by immersion.
I come on my Statement of Christian experience, but I have a disability and baptism by immersion is detrimental to my well-being. I request that this form of baptism be waived.
I come on my Statement of Christian experience and prior baptism by immersion. I have resigned from this or another church of faith and order. I request to be reinstated into Membership with this church.

I understand that this decision and commitment must be followed by a favorable vote of the Church at the next Business Meeting.