Thank you for your interest in becoming a member of New Wine Church.

Please ensure that all sections of the form are completed including the reference section;

You will need to send a passport-size photograph by email to [email protected].

Personal Details

Title *

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First Name *

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Surname *

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Email *

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Mobile *

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Address *

Address 1 *

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Address 2

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Address 3

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Town *

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County *

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Postcode *

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Country *

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Date Of Birth *

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Nationality *

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Relationship Status *

Please choose a relationship status

If married, please provide Full Name of Spouse

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Does your spouse attend New Wine Church? *

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Have you received Jesus Christ as Saviour? (i.e.become born again) *

Yes

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Date you received Christ as Saviour

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If Yes, briefly describe how you became a born-again Christian:

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Do You Operate In Any Spiritual Gifts?

Yes

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If yes, please specify

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Branch you wish to join *

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When Did You Start Attending New Wine Church?

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Which Church Did You Attend Before NWC?

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Which team do you belong to in New Wine Church?

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Do you attend any Cell Group in Church? *

Yes

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If you attend a Cell Group, please specify which one.

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Education/Employment *

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Occupation *

Please state what work you do or your current job title.

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Name of your next of Kin *

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Telephone number of your next of Kin *

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Referee's Details: (From a Pastor, Minister, Team Leader or Cell Group Leader)

Referee's Title *

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Referee's First Name *

First name *

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Middle name(s)

Surname *

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Referee's Surname *

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Referee's Email

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Referee's Mobile *

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Thank you for completing the Church Membership form.

Your application will be handled with strict confidentiality in accordance with the New Wine Church Privacy Policy, a copy of which is available from the church office or from our website (www.newwineinternational.com).

By completing this form you agree to our Privacy Policy

Please remember to send your accompanying passport-size photograph by email to [email protected].