MembershipApplication Personal InformationYour Name First Last Spouse's Name First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Work PhoneHome PhoneEmail Marital StatusSingleMarriedDivorcedWidowedAnniversary Date Additional InformationDate you started attending Harvest Muskoka Baptism*I am requesting baptism. Please contact me for the next baptismal service.Yes, I have been baptized (believers baptism) in the name of the Father, Son and Holy Spirit after conversion, as a testimony to my faith in Christ.When? Where?Harvest Essentials I have completed all three Harvest Essentials classes. Date Previous Church Membership Yes, I have previously been a member of another church. What is the name of the church(es), and when did you last attend (approximately)?Are there any outstanding issues between you and the leadership/members of any previous churches? Household InformationPlease complete the following information for our church database. It is helpful to have as much information as possible, but feel free to omit any information that you are not comfortable providing to us. None of this information will be shared with any outside organization.Head of HouseholdNameDate of BirthCell NumberEmail Address SpouseNameDate of BirthCell NumberEmail Address ChildNameDate of BirthCell NumberEmail Address Additional Information(summer or college addresses, children or spouse with different last name, anything else you would like us to know) Consent ReleaseBy signing this form, you give your consent to Harvest Bible Chapel Muskoka to use this information for the purposes of its operation.Date Signature My Story1. “I was...”What was your life like before you accepted Jesus Christ as your Lord and Saviour?2. “But God...”How did you come to surrender your life to Jesus Christ?3. “And now...”What is the Lord doing in and through your life now? Walk with ChristSmall GroupI am already in a Small GroupI’m not in a Small Group; please assign one to me!Small Group that I am a part ofWork for ChristAreas you are currently servingAreas you are interested in servingGivingInterested in Pre-authorized GivingYesNoDoctrinal StatementPlease Read Our Doctrinal Statement (myharvestchurch.ca>about>what we believe>doctrinal statement) I have read and will submit to the doctrinal statement This iframe contains the logic required to handle Ajax powered Gravity Forms.