GRACE BIBLE CHURCH

P.O BOX 3762

GILLETTE, WYOMING 82716

MEMBERSHIP REQUEST APPLICATION

NAME: ______________________________________ DATE: ___________________

ADDRESS: _____________________________________________________________

TELEPHONE: (Home) ____________________ (Work) ________________________

Please tell us in a few words about your acceptance of Jesus Christ as Lord and personal Savior. Explain what the Lord has done and is doing in your life. Please list also possible areas of experience or interest where you would be willing to serve at Grace Bible Church.

Please circle one answer for each question below:

Have you read the Articles of Biblical Faith,

Constitution, and By-Laws of Grace Bible Church in its entirety? YES NO

Are you in complete agreement with the Articles of Biblical

Faith (Section 1) and Constitution of Grace Bible Church? YES NO

Are you in complete agreement with the Articles of Biblical

Faith (Section 2)? If "NO", use the back for explanation. YES NO

Have you been baptized by immersion as a believer? YES NO

If not, would you be willing to be baptized if given

the opportunity? YES NO

Signature ___________________________________________ Date ____________

Please give this form to the pastor or one of the Elder Board members.