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Become a member online

Please take a moment to fill out some information about yourself so that we can better get to know you. Welcome to the family!

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Name *

First

Last

Address *

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City

State

Zip Code

Country

Email *

Phone Number *

Alternate Phone Number *

Name of Company *

Position *

Work Phone Number *

Date of Birth *

Current Age *

Gender *

Marital Status *

Will your spouse be joining also? *

Spouse's Name *

First

Last

Spouse's Date of Birth *

Spouse's Current Age *

Spouse's Company *

Spouse's Work Number *

Spouse's Email *

Previous Church Home *

Pastor's Name *

City, State *

Church Telephone *

Do you have any other relatives who are members at NDCCC? *

Do you have any children under the age of 17 who will be attending NDCCC? *

Number of children *

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