Cornerstone Membership Form

NAME *

First

Last

ADDRESS: *

MOBILE NUMBER: *

FACEBOOK USERNAME: *

WHAT'S THE BEST WAY WE CONTACT YOU? *

• MOBILE NUMBER
• FACEBOOK
• OTHERS (PLEASE SPECIFY)

GENDER: *

BIRTHDAY: (MM/DD/YYYY) *

CIVIL STATUS: *

ATTENDS CORNERSTONE SINCE? (MM/YYYY)

WATER BAPTIZED? *

• YES
• NOT YET

CLIFE MEMBER? *

• YES
• NOT YET

IF YES, WHO IS YOUR CLIFE LEADER?

Phone

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