Join us for our Faith in Life Conference, October 10-11. Find more information and register under Resources.
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Membership Application
Thank you for your interest in applying for membership at Roots Community Church! This online application will collect your basic information and allow you to use an electronic signature to express your understanding of and agreement with our Statement of Faith and Church Covenant. Both of these documents can be viewed here:
Statement of Faith
Church Covenant
After the completion of this application we will reach out to you to schedule an interview with a pastor.
*Because we want to know your story in your own words in every part of this application, please do not use any generative "AI" chatbots (e.g., ChatGPT, Claude, Gemini, etc.).
Contact and Family Information
First Name
Last Name
Email
Phone Number
Birthdate
Month
January
February
March
April
May
June
July
August
September
October
November
December
Date
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
Year
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Address
Apartment, suite, etc.
City
State
Zip/Postal Code
Marital Status
Single
Married
Widowed
Separated
Divorced
I'd rather not say
Spouse's Name
Do you have any children?
Yes
No
What are their Names and Ages
Testimony and Church Background
Have you ever been baptized?
Yes
No
When and where?
What church did you last regularly attend?
What was your reason(s) for leaving?
Have you ever been under church discipline or asked to leave a church?
Yes
No
What happened?
Please write out a brief description of your conversion.
Membership Affirmations
Have you read and are you in agreement with our Statement of Faith?
Yes
No
What are your concerns or hesitations?
Have you read and are you in agreement with our Church Covenant?
Yes
No
What are your concerns or hesitations?
With love and restoration as our goal for a wayward member, do you understand that Roots Community Church will employ church discipline according to the steps outlined in Matthew 18:16-18 when absolutely necessary?
Yes
No
Electronic Signature
I, the undersigned, wish to commit to membership with Roots Community Church. I have read and affirm both the Statement of Faith and Church Covenant.
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