Visitor/New Member Information Form

Thank you so very much for visiting with us hear at KAMC.  We would like to get more information about you.  Please take a few moments and fill out the form below.

Again we appreciate your time shared with us and we look forward to seeing you again soon, God bless.

Visitor/New Member Information Form

Personal Information

* I am a (check all that applies):

Visitor

First time attendee

Need prayer

Have questions about Christianity

Would like to talk to a minister

* Name

First

Last

* Address

Street Address

Address Line 2

City

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State

ZIP Code

Phone No.

Date of Birth

* Email address

Email

Confirm Email

I make the following public confession

* My Confession

Already accepted Christ as Lord and saviour

Desire to join Kingdom Assemblies Missionary Church

Desire to be baptized into the Church

I want to rededicate my life to Christ

I want to serve in the following area:

List any area of ministry you desire to serve in.