Church Membership Form

NDYM MEMBERSHIP ENROLLMENT FORM
All information on this form is strictly confidential
Full Name
First NameLast Name
Gender
Date of Birth
MonthDayYear
E-mail
Mobile Phone Number
PrefixNumber
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
Your Parish
Your Vicar
Name of Parent/Guardian (s)
Have you been enrolled before?
If Yes, When were you enrolled?
What are some of your talents and/or giftings?
What role do you play in your church youth group, if any?
Are you a born again Christian?
If YES, Could you share with us a short testimony of your salvation?
Please remember that a registration fee of KES. 200 will be required to process your NDYM Card. You can MPESA the same to the DYA on the number provided below.
All correspondence to The Director Of Youth Affairs Office, Imani Hse. Nairobi || P.O. Box 72846 00200 City Square || E-mail: ndymevents@gmail.com || Cellphone: + 254 722 960 847 || FACEBOOK: Nairobi Diocese Youth Ministry-NDYM ACK
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NDYM MEMBERSHIP ENROLLMENT FORM