Revival Bible Church

Membership Application

Pastor Wilhelm Dueck
Address: 350 North Blackstock Road, Spartanburg, SC 29301

First Name

Last Name

Phone Number

Email

Birthdate

Baptism Date

Marital Status

Date of Marriage

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Add children?

Child - First Name

Child - Last Name

Birthdate

All of the above who were baptized have accepted Christ as their personal Savior.

Yes

No

Are you a member of a church?

Yes

No

If “yes” have you secured your transfer or release (letter from a former pastor)?

Yes

No

Would you like us to take care of that for you (we will contact your former church) ?

Yes

No

Name, Phone # and Address of your Former Church

Which ministries were you involved at your former church?:

Which ministry would you like to be involved in at Revival Bible Church?

Are you planning to attend small group?

Yes, I would like more information about this

No

Signature

If you have any questions, please, call or text us:
Pastor - Wilhelm Dueck (913) 485-5293
Admin - Andrey Vovk (916) 596-8871
Deacon - Igor Bondarev (360) 487-0157