Calvary Revival Church Chesapeake
Church Membership Application
(One form per family, please!)

Note: The fields with an asterisk are required and can not be left blank. You have 10 lines (70 characters per line) to answer the questions containing scrollable textboxes.

Date (*)

Please include a date.
Mr/Mrs/Miss/Ms (*)

Please type your full name.
Address (*)

Please type your street address.
City (*)

Please type your city name.
State (*)

Please type your state name.
Zip Code (*)

Please type your zipcode.
Home Phone

Please type your home phone number.
Work Phone

Please type your work phone number.
Cell Phone

Please type your cell phone number.
E-mail Address

Please type your email address.
(Please list the names, ages and birth dates of spouse and/or children living at home. List yourself first.) (*)

This question is required and must be answered.
Have you received the Jesus Christ as your Lord and Savior? (*)
yes no
Invalid Input
If so, when?

Invalid Input
What evidence in your life proves your conversion/regeneration?

This question is required and must be answered.
Have you been baptized? (*)
yes no
Invalid Input
If so, when?

Invalid Input
History of Church Membership - Please list the name(s) of any church that you've joined in the past. Include the dates of membership, the reason for leaving and note if you were a member in good standing (i.e. consistent attendance, served in a ministry, etc.). Also, please let us know if you informed the leadership of the church(es) before you left? (*)

This question is required and must be answered.
Read the following: Vision Statement, Meet Jesus, Know Jesus and Serve Jesus. Do you understand and agree with our Vision? (*)
yes no
Invalid Input
Please explain: (*)

This question is required and must be answered.
Read the following: What We Believe. Do you understand and agree with our Doctrine? (*)
yes no
Invalid Input
Please explain: (*)

This question is required and must be answered.
Do you understand and agree with Family Integration? (*)
yes no
Invalid Input
Please explain: (*)

This question is required and must be answered.
Read the following: Family Integration. After reading this, are you prepared to disciple your family and be accountable to leadership? (*)
yes no
Invalid Input
Please Explain: (*)

This question is required and must be answered.
Please share a few thoughts about why you want to join Calvary Revival Church Chesapeake? (*)

This question is required and must be answered.
Please let us know where you would like to serve if/when you join the CRCC family? (*)

This question is required and must be answered.
Tell us what you expect to gain from CRCC? How can we serve you and your family? (*)

This question is required and must be answered.
Tell us a little about yourself and your family. What is your occupation? What are your hobbies, skills, gifts/talents? (*)

This question is required and must be answered..

  

Dr. Carlton C. Mcleod, Senior Pastor
Calvary Revival Church (Chesapeake)
(757) 216-4112