1. HOPE AGLOW EMPOWERMENT CENTER
CONNECTION - ALTAR CARE - MEMBERSHIP
PERSONAL INFORMATION
Please Check Title: Dr. Pastor Minister Mr. Mrs. Ms. Miss Date:
Please Print Full Name (include middle initial): Fredericksburg Campus
Woodbridge Campus
Home Phone:
Date of birth (mm/dd):
Email:
(membership only)
Cell:
Current address:
City: State: ZIP Code:
Marital Status: Married Divorced Widowed Single Engaged
SPOUSE INFORMATION
Please Check Title: Dr. Pastor Minister Mr. Mrs. Ms. Miss
Please Print Name (include middle initial):
Home Phone:
Date of birth(mm/dd):
Email:
(membership only)
Cell:
NAME AND AGE OF CHILDREN
Name: Age: Name: Age:
Name: Age: Name: Age:
PURPOSE FOR COMPLETING THIS FORM (CHECK ALL THAT APPLY)
First Time Guest Receive Salvation
Desire to become a member of Hope Aglow Empowerment Center Rededicated my life to Christ
Request More Information (check the ministry area from below) Need help studying the bible
I would like to volunteer (check all ministry interests from below) Other (please explain)
Ministry Areas and Volunteer Opportunities I desire a telephone call and/or email for:
Men’s Ministry (Watchmen on the Wall) Prayer
Women’s Ministry (Kingdom Women) Spiritual Guidance
Singles Ministry (Living in Full Empowerment – L.I.F.E) Church Activities
Senior Ministry (High Rollers) Ministry Fellowships
Young Adult Ministry (Righteously Empowered 2B Leaders)
Youth Ministry (Crossfire)
Maintenance Ministry
Helping Hands Ministry
Children’s Ministry* (for information only/not volunteering)
* Additional ministries available upon completion of membership orientation.
How did you hear about us:
TV Flyer Shepard’s Guide Newspaper Post Card Internet Annual HAEC Picnic Community Event
HAEC Member (Please Print Name):
-- STOP HERE -- 2ND PAGE FOR NEW MEMBERS ORIENTATION
HAEC Assimilation Form 1 HAEC 0077 updated 08/27/2012

2. HOPE AGLOW EMPOWERMENT CENTER
CONNECTION - ALTAR CARE - MEMBERSHIP
OTHER PERSONAL INFORMATION (membership only)
Gender: Male Female Date Joined HAEC:
Wedding Anniversary Date: (month/day) Date Converted:
Family National Origin: Date Water Baptized:
Best time to contact you: Morning Mid-Day Evening Date Filled with Holy Spirit:
Career Field/Occupation: (self) (spouse)
TOP THREE AREAS OF VOLUNTEER INTEREST (membership only)
Anchor of Health Ministry Marketing Ministry Covenant Keepers Marriage Ministry
Baptism Ministry Prison Ministry Ground Breakers/Prayer Ministry
International Ministry Seeds of Empowerment Children’s Ministry Bookstore Ministry
Information & Technology Transportation Ministry Membership Management Services Ministry
Altar Care/Kingdom Builders Ministry Audio/Media Ministry Outreach/Evangelism Ministry
Porter/Greeter Ministry Fine Arts Ministry (Choir, Musician, Dance)
OTHER HAEC FAMILY MEMBERS LIVING IN YOUR HOUSEHOLD
Member’s First & Last Name Relationship to You Member’s Date of Birth
EMERGENCY CONTACT (membership only)
Name of a relative not residing with you:
Address: Phone:
City: State: ZIP Code:
Relationship:
SIGNATURES (membership only)
I (we) desire to serve my Savior, Master and Lord Jesus Christ through the ministry of Hope Aglow Empowerment Center. To God be the glory in my life.
Signature of New Member:
Date:
Signature of New Member:
Date:
Signature of New Member:
Date:
Signature of New Member:
Date:
****** OFFICIAL USE ONLY *******
Follow-up information and comments (i.e. call, letter, text, in-person)
Date:
Date:
Date:
Date:
Date:
HAEC Assimilation Form 2 HAEC 0077 updated 08/27/2012