CHURCH MEMBERSHIP APPLICATION National Spiritualist Association of Churches NAME OF CHURCH CITY, STATE Name Street address City, State, Zip Phone Birthday (month, day) Email Occupation (optional) Have you ever been a member of an NSAC church F Yes F No (See Previous Member of Another Church below.) If yes, name of most recent NSAC church Date joined Date terminated Reason for leaving LIST ALL OTHER CHURCHES IN WHICH YOU HAVE HELD MEMBERSHIP HAVE YOU EVER BEEN CONVICTED OF A FELONY F Yes F No If yes, this form must be referred to the NSAC Board of Trustees for review..
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