Your Email:
INSTRUCTIONS: Applications should be completed by each applicant; e.g. a husband and wife both need to complete their own applications. Minors should have written permission from a parent or guardian. When finished, please click submit at the bottom of this page or print your results and mail to: Good Works Community Church, Post Office 744, Edenton, NC. 27932
Full Name
Date of Birth
Marital Status
Marriage Anniversary Date
Phone Number
Mailing Address
University Student
School Attending
Number and ages of spouse, children and pets
Occupation and education
Recreational interests and hobbies
I have received Jesus Christ as my Lord and Savior.
I have not received Jesus Christ as my Lord and Savior.
If I should die right now I know where I shall go because
I have been baptized since my decision to follow Christ.
I need to be baptized.
Since becoming a Christian the following changes have occurred in my attitudes, desires and behaviors.
I am a member of another Church.
Phone Number
Pastor's Name
My reason for leaving
To GOOD WORKS COMMUNITY CHURCH: I would like to join this church because
I hereby make application for membership and subscribe to the Statement of Faith and Bylaws of the Church.*
Date of Application
Verification Code:
Insert above code:
 * Required

Copyright © 2019  Good Works Community Church • Hertford, North Carolina • (252) 404-9088