Praise Temple Global Church Registration
Please fill out this form and click submit.
Name
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Country
*
Date of Birth
*
Age
Marital Status
Please select one option.
Single
Married
Divorced
Widowed
Occupation
Work #
Nearest Kin
In this section, provide the name of a person we can contact in case of emergency. Provide their relationship to you, address, and phone number.
Name of Emergency Contact
Relationship of Emergency Contact
Emergency Contact Phone Number
Emergency Contact Address
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Emergency Contact Country
Desired Public Commitment
Please check all that apply
*
Please select all that apply.
Accepts Christ as personal Lord and Savior
Desires to join Global Church
Desires membership in this church as an associate member/watchcare
Please upload a photo.
Upload (8MB)
Submit
Description
Please fill out this form and click submit.
×
Please Fix the Following