Membership Information Form

Thank you for your interest in joining Crosstown Chicago! We are honored that the Lord has led you to us to take your next step in faith. Please share the requested information with us and someone from our team will reach out to lead you forward in the next steps. We pray God richest blessings upon you as you accept God's invitation to join the family of God at Crosstown Chicago.

Please tell us a little about yourself

Title

*

Please select one option.

Sister Brother

Name

*

Email

*

Address

*

Mobile Phone Number

*

Home Phone Number

Subscribe to receive texts?

*

Please select one option.

Yes No

Date of Birth

*

Marital Status

*

Please select all that apply.

Single Married Separated Divorced Widowed

Wedding Anniversary, if applicable

Racial & Ethnic Identity

Please select all that apply.

Black/African-American Indigenous/American Indian Asian Hispanic/Latino White

Please check all that apply

*

Please select all that apply.

I want to receive Christ as my Lord & Savior I would like to be baptized I would like to join this church I would like to transfer my membership to this church Evangelism & Outreach Leading Worship - Instrumentation Leading Worship - Singing

Name of previous church, if applicable

Name of previous church pastor, if applicable

Most recent church address, if applicable

Most recent church phone number, if applicable

College alma mater & year of graduation, if applicable

Employer

Occupation

Work Email Address

Please share an emergency contact with us - just in case!

Emergency Contact Name

Relationship

Phone Number

Description

Thank you for your interest in joining Crosstown Chicago! We are honored that the Lord has led you to us to take your next step in faith. Please share the requested information with us and someone from our team will reach out to lead you forward in the next steps. We pray God richest blessings upon you as you accept God's invitation to join the family of God at Crosstown Chicago.

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