Get Connected

WCCI Membership Form

This form is comprised of 1 section, please carefully read and complete.

First name

Surname

Email address

Mobile number

Physical address

Date of birth

Marital status

Occupation

Number of family members in your current household

What date were you Born Again?

Are you baptized in water?

When were you baptized in water?

Do you wish to be baptized in water?

Dependants

Dependants

Dependants

Dependants