CLFC Membership Application

Don't Forget! To complete the Membership Registration Process, be sure to sign up for an upcoming New Members' Class after you submit your application if you have not already done so!

Please direct only comments and questions about our site to our .

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Name:	Last	First	Middle
Preferred Name:		Date of Birth:
Marital Status:
PLEASE NOTE: If you are not married, please understand that we do not accept cohabitating (living together unwed). Members must be single or married.
Address:
City:		State:	ZIP:
Home Phone:		Cell Phone:
Work Phone:		OK to call at work? Yes No
Email Address:
How did you hear about CLFC? if other:
Military Branch: Status: Rank:
Occupation:		Business Name:
Educational Background: (List colleges attended, degrees earned, or special fields of study)
Received Jesus Christ as Lord and Savior? Yes No Date:
Received the Baptism of the Holy Spirit? Yes No Date:
Spouse :	Last	First	Middle
Wedding Anniversary:
Is spouse joining CLFC with you? Yes No (If yes, please fill out information about your spouse below.)
If spouse is not joining CLFC, would he or she object to your being an active member and giver to CLFC? Yes No
Why or why not?
Spousal Information:
Preferred Name:		Date of Birth:
Military Branch: Status: Rank:
Occupation:		Business Name:
Work Phone:		OK to call at work? Yes No
Cell Phone:
Email Address:
Spouse received Jesus Christ as Lord and Savior? Yes No Date:
Spouse received the Baptism of the Holy Spirit? Yes No Date:
Educational Background: (List colleges attended, degrees earned, or special fields of study)
Children Who Will Be Joining or Attending With You: (If children are 18 or older and are joining, please, fill out a separate application for each.)
Number of children:
Name:		Birthdate:	Gender:
1.
2.
3.
4.
5.
6.
7.
8.
Other Family Members Living In The Home:
Name:		Relationship:
1.
2.
Emergency Contact Information:
Name:		Relationship:
Phone:
Address:
City:		State:	ZIP:
Additional Information: (Please give any other necessary information about yourself.)