New Member

SIGNATURE

IF THE FOLLOWING IS TRUE IN YOUR LIFE, PLEASE SIGN BELOW TO BECOME A MEMBER OF COTR: I have accepted Jesus Christ as my personal Lord and Savior according to Romans 10:9-10 and I believe God has called me to be an active part of the Church on the Rock family. I understand that active members of Church on the Rock are faithful in attendance, prayers, serving others, tithing and giving.

Signature*

Please type your full name (and your spouse's full name if joining) as your signature.

Today's Date*

YOUR INFORMATION

Title

Mr.
Mrs.
Ms.

Fulll Name*

First Last

Preferred Name

Address*

Street Address Address Line 2 City State ZIP Code

Cell Phone

Other Phone

Email*

Date of Birth*

Approximate Date You Were Born Again

Occupation

SPOUSE

Spouse's Full Name (if joining)

First Last

Spouse Cell Phone

Spouse Other Phone

Spouse Email

Spouse Date of Birth

Approximate Date Spouse Was Born Again

Spouse Occupation

CHILDREN

CHILDREN UNDER 18 ALSO JOINING (young adults 18 or over should complete their own form)

Child Name & Date of Birth

PLEASE TYPE THE NAME AND DATE OF BIRTH FOR EACH CHILD

MEMBER INTERCESSORS

One of the wonderful and unique ministries of COTR is our Member Intercessors Team. Each volunteer member of this team is assigned certain COTR families to pray for regularly and contact, usually by phone, for prayer requests once a month. As a COTR member, you will now have the opportunity to be blessed by a personal intercessor for your family… someone who cares enough to take the time to pray for you regularly! Note: If you later change your mind, and want to be added or removed from the prayer list, simply e-mail us at info@cotr.tv and let us know.

Would you like to have a membership intercessor assigned to pray for your family?*

Yes
No

In this section

SIGNATURE

YOUR INFORMATION

SPOUSE

CHILDREN

MEMBER INTERCESSORS