Membership Update Form Bethel Step 1 of 2 50% Bethel A.M.E. CHURCH 714 Savannah Street, Mobile, AL 36603 The Rev. Trevor E. Woolridge, PastorDate(Required) Month Day Year NEW MEMBER'S INFORMATION FORMYour Name(Required) First Middle Last Gender Male Female Registered Voter? yes no Your Address Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Birth Date Month Day Year Marital Status Single Married Divorced Seperated Widow(er) Spouse Name First Last Anniversary Date Month Day Year Employer Occupation HomeWorkCellCell Phone Provider Your Email Address(Required) Email Address Confirm Email Address Accepted Christ? yes no Reclaimed Have you Been Baptized? yes no When did you join Bethel A.M.E. church? I am a member of the following Boards – AuxiliariesEvery person 18 or older must complete their own form. 17 and younger must be completed on the next page. ADD CHILDREN 17 OR YOUNGER ONLYChildrenFull NameAddressCell PhoneCell ProviderBirthdayOccupation or Student Add RemoveNameThis field is for validation purposes and should be left unchanged. Δ
