Join ECC MEMBERSHIP APPLICATION Date Joining (mm/dd/yyyy) * Will You Be a Campus Member or Online Member? * Campus Member - Attends one of our physical locations Online Member - Lives out of the area. Attends services via the Live Webcast. First Name Last Name Address 1 Address 2 City State Postal Code Country * AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCôte d'IvoireCroatia (Hrvatska)CubaCyprusCzech RepublicCongo (DRC)DenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Islas Malvinas)Faroe IslandsFiji IslandsFinlandFranceFrench GuianaFrench PolynesiaFrench Southern and Antarctic LandsGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong Kong SARHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SARMacedonia, Former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe Email Phone Number * Male/Female Male Female Marital Statul Married Single Divorced Separated Widowed Date of Birth MM/DD/YYYY SPOUSE INFORMATION IF MARRIED (If married, click to tell us about your spouse) If you are married tell us about your spouse. Single? Skip this section. Is Your Spouse Joining Also? Yes No Name First Last Last Email Address Website City Date of Birth MM/DD/YYYY Cell Phone Home Phone Work Phone Number Current Employer Employer Address Employer Phone Number Position OTHER FAMILY MEMBER JOINING (click to add other family member) Add any additional family members who are joining with you. Only include family that for whom you are responsible. Name First Last Name Last Email Date of Birth MM/DD/YYYY Cell Phone Relationship to Applicant Son Daughter Nephew Niece First Name First Last Name Last Email Date of Birth MM/DD/YYYY Cell Phone Relationship to Applicant Son Daughter Nephew Niece First Name First Last Name Last Email Cell Phone Relationship to Applicant Son Daughter Nephew Niece Date of Birth MM/DD/YYYY First Name First Last Name Last Email Date of Birth MM/DD/YYYY Cell Phone Relationship to Applicant Son Daughter Nephew Niece First Name First Last Name Last Cell Phone Relationship to Applicant Son Daughter Nephew Niece Email Are you currently in school? If yes, please explain (Include the name of the school and time remaining to complete the program. EMPLOYMENT INFORMATION (Click to tell us where you work) Let us know a little information about where you work. Current Employer Employer Address Employer Phone Number Position GENERAL INFORMATION (Click to give us a little more info) Your'e almost done. Just give us a little more information. How Did You Hear About Us? Internet Television Radio Social Media Word of Mouth If Applicable, Please Name Family or Friends Currently Attending Enlightened Christian Center in Person For the First Applicant, Please List Any Skills, Talents, Trades, and Gifts You Have For Your Spouse, if Applicable, Please List Any Skills, Talents, Trades, and Gifts You Have For Any Other Member Joining, Please List Any Skills, Talents, Trades, and Gifts You Have For Any Other Member Joining, Please List Any Skills, Talents, Trades, and Gifts You Have For Any Other Member Joining, Please List Any Skills, Talents, Trades, and Gifts You Have For Any Other Member Joining, Please List Any Skills, Talents, Trades, and Gifts You Have For Any Other Member Joining, Please List Any Skills, Talents, Trades, and Gifts You Have Family Photo Drop a file here or click to upload Choose File Maximum upload size: 268.44MB Please upload a family picture if you wish. It helps us put a name with a face.
