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NDEC Membership Application
*NDEC does not believe in Dual Membership
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Full Name
*
Your answer
Mailing Address
*
Your answer
Home Phone Number
*
Your answer
Cell Phone Number (Optional)
Your answer
E-Mail Address
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Marital Status
*
Single
Married
Divorced
Separated
Widowed
Gender
*
Male
Female
Did you attend a previous church?
*
Yes
No
Name of previous church?
Your answer
Are you still a member?
Yes
No
Clear selection
What is the pastor's name?
Your answer
Why did you leave?
Your answer
Did you serve in any capacity?
Yes
No
Clear selection
What capacity did you serve?
Your answer
Do you wish to serve in a ministry at NDEC?
*
Yes
No
Which Ministry?
Your answer
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