Shiloh Webchurch Application - Patricia King Ministries

MAIN APPLICANT

Select One*

Name*

First Last

Middle Initial

Date of Birth*

Marital Status*

Email*

Enter Email Confirm Email

Facebook Name (please put your FB name so we know who to invite to the FB private group):

Main Phone*

Secondary Phone

Best Time to Call

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Mailing Address (if different)

Street Address City State / Province / Region ZIP / Postal Code Country

Spouse

Will Your Spouse be Joining the Webchurch? (no extra charge)

Yes
No

Name

First Last

Date of Birth

Email Address

Enter Email Confirm Email

Main Phone

Secondary Phone

Children

How many children aged 12 and under will be joining you in webchurch? (Enter 0 if none)

Please Enter Children's Names, Dates of Birth and Male or Female- Only if they are joining the Webchurch.

Teen

Number of Teens joining you in webchurch? (Enter 0 if none)

Please Enter Teens Names, Dates of Birth, Male or Female - ONLY if they are joining the Webchurch. Include email address for the Teen Pastors to contact them.

Comments

Do you want your contact information (name, email & phone only) available to:*

Web Pastor Only
Web Pastor and Congregation

Comments

How did you hear about Shiloh Webchurch?*

Why do you want to join Shiloh Webchurch?*

Comments

How did you meet the Lord, and when?*

Describe your walk with the Lord. Examples: Vibrant, growing, weak, struggling, or dormant. If you’d like, please explain.*

Are you currently involved in a local church? If so, please describe your involvement.*

All information will be kept confidential, in a secure place, and will only be shared with the Shiloh Webchurch Pastor. (and Congregation If permission is given)

When you complete this personal information page, click the SUBMIT button and then complete the second step where you will submit your $35 Shiloh Webchurch membership fee. Note, these are monthly automatic recurring payments. Your completed application may take up to 2 business days to process.

Note: The $35 Monthly Administration Fee is NOT tax deductible and will not be included in your year-end tax receipt. Any tithes and offerings above the Monthly Administration Fee will be tax deductible.