Crossroads For Life Ministries

Do you want to become a member of this ministry? (Required)

First Name (Required)

Last Name (Required)

What is your date of birth? (Required)

Email Address (Required)

Address (Required)

Please Include: City, State, Zip Code, Apt/Unit/Suite Number

Phone Number

Please list best form of contact

Are you married? (Required)

If Yes, please list spouse name

Please include your wedding date

Do you have children? (Required)

If yes, please list first and last name along with date of birth.

Employer Name

If self-employed list name of your business.

Emergency Contact Name

Emergency Contact Number

Would you like to be contacted monthly? (Required)

This is considered a monthly discipleship contact

Would you be interested in completing discipleship courses? (Required)

These classes are offered to new members and anyone actively involved in ministry

I am good at...

List your passion!

I am interested in... (Required)

For instance, feeding the hungry, serving the homeless community, teaching, dancing, etc.

Crossroads For Life Ministries

12591 Veterans Memorial Hwy, Douglasville, GA 30134