New Member Form

Congratulations!
Fill out the New Member Form below

Date completed Gateway*
Quiz Score*

What did you score on your online Gateway test
Membership*
How do you plan to attend church. On campus or e-church (online only) out of state
First Name*
Last Name*
Main Phone*
Alternate Phone
Email*
Birth Date*
Marital Status*
Military Branch
Occupation*
Employer
Emergency Contact*
First Last
Phone*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Household Information
Spouse Name
First Last
Birth Date
Email
Phone

Children's Name

First Name	Last Name	Date of Birth

LOCATION

2845 Lindell Rd
Las Vegas NV 89146

A Time of Prayer 9:00 am (on campus) 1st Sundays (Feb-Oct)
Worship Service On-Campus & Online 10 am PST

Bible Study with Pastor Clinton House
Concluded for 2024 Check schedule for special services

2845 Lindell Rd
Las Vegas NV 89146

A Time of Prayer 9:00 am (on campus) 1st Sundays (Feb-Oct)
Worship Service On-Campus & Online 10 am PST

Bible Study with Pastor Clinton House
Concluded for 2024 Check schedule for special services