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Home
Who We Are
Become A Member
Children/Youth Membership
Our Leadership
Media & Sermons
Calendar
Contact Us
Get Involved at NVBC
Connect With Us
Give
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Become A Member
New Visions Baptist Church New Membership Affirmation Form
Membership Classification
(Required)
Choose One
On-Site Membership
Virtual Membership
Gender
(Required)
Choose One
Male
Female
First Name
(Required)
Last Name
(Required)
Birthdate
(Required)
Address
(Required)
City
(Required)
State
(Required)
Choose One
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
British Columbia
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
Michigan
Micronesia
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
North Carolina
North Dakota
Northern Mariana Islands
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands, U.S.
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
(Required)
Cell Phone
E-mail Address
(Required)
Emergency Contact Name
(Required)
Emergency Contact Phone Number
(Required)
Occupation Status
(Required)
Choose One
Current
Retired
Unemployed
Medical Conditions
Marital Status
(Required)
Choose One
Single
Married
Widowed
Do you have children under the page of 18 in your household?
(Required)
Choose One
Yes
No
Submit Form
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