This document is a membership form for The Church of Pentecost Fanmilk District English Assembly. It requests basic information such as name, date of birth, contact details, education history, date of baptism, departments and ministries involved in. The form is to be signed and dated by the applicant and includes a space for a passport photo. It also has a section for office use only to record details of transfer or positions held.

1. THE CHURCH OF PENTECOST
FANMILK DISTRICT – ENGLISH ASSEMBLY
MEMBERSHIP FORM
THE CHURCH OF PENTECOST – FANMILK DISTRICT
ENGLISH ASSEMBLY
MEMBERSHIP FORM
PASSPORT SIZE
PICTURE
B A S I C I N F O R M A T I O N
Name Gender M F
Date Of Birth Day Month Year Age Home Town
Marital Status Single Married Divorced Widowed
Occupation
C O N T A C T I N F O R M A T I O N
Mobile Face book Username
Whatsapp Contact Email Address
E D U C A T I O N A L I N F O R M A T I O N
Level Of Education JHS SHS Tertiary Date Of Completion
Name Of School Course Of Study
M I N I S T R Y
Date Baptized Day Month Year Baptized By
Date Transferred To
Local
Day Month Year District Baptized
Belong to at least one of these departments in church
Music Drama/ Choreography Win Team Prayer Wing
Belong to at least one of these one of these ministries in church
Youth Evangelism Men Women Children
Signed:…………………………………………
Date: …………………………………………..
FOR OFFICE USE ONLY
Date transferred out of Local: ……………………………………………………. Reason (s) for transfer:…………………………………………………………………………………………….
Positions held in church
Presiding Elder’s Remarks:………………………………………………………………………………………
………………………………………………………………………………………
……………………………………………………………………………………...
Signed:…………………………………………
Year Position Held