WHC Next Step Class

Congratulations for taking the first step to become a member of WHC.

Fields marked with * are required.
Personal Information
Full Name * Title First Middle Last Suffix
Enter your full name, including second and middle names.
Goes by:
Gender *

Gender Female Male
Birthday * / MM / DD YYYY
Marital Status *
Upload a recent picture of you

Attach Files Attach Files
If you are a student, which College/University or High School do you attend?
Contact Information
Preferred Phone Number * - ### - ### ####
Type *
Email Address *
Home Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Family Information
Are you a parent or legal guardian of children 0 to 18 years old? *

Are you a parent or legal guardian of children 0 to 18 years old? Yes No
How many? *
Must be a number between 1 and 4
If you have more than 4 minor children, list their information in the field "close relatives who attend church"
Spouse's Name * First Middle Last
Enter your full name, including second and middle names.
Spouse's Goes by:
Spouse's Birthday * / MM / DD YYYY
Wedding Anniversay * / MM / DD YYYY
Upload a recent picture of your spouse

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Does your spouse attend WHC? *

Does your spouse attend WHC? Yes No
Has your spouse recently submitted the Next Step class form AND provided information about your minor children? *

Has your spouse recently submitted the Next Step class form AND provided information about your minor children? Yes No
First Child Info
Child's Name * First Middle Last
Enter your full name, including second and middle names.
Child's Goes by:
Child's Gender *

Child's Gender Female Male
Child's Birthday * / MM / DD YYYY
School Grade *
Upload a recent picture of your child

Attach Files Attach Files
Child's Cell Phone Number - ### - ### ####
Child's Email Address
Second Child Info
Child's Name * First Middle Last
Enter your full name, including second and middle names.
Child's Goes by:
Child's Gender *

Child's Gender Female Male
Child's Birthday * / MM / DD YYYY
School Grade *
Upload a recent picture of your child

Attach Files Attach Files
Child's Cell Phone Number - ### - ### ####
Child's Email Address
Third Child Info
Child's Name * First Middle Last
Enter your full name, including second and middle names.
Child's Goes by:
Child's Gender *

Child's Gender Female Male
Child's Birthday * / MM / DD YYYY
School Grade *
Upload a recent picture of your child

Attach Files Attach Files
Child's Cell Phone Number - ### - ### ####
Child's Email Address
Fourth Child Info
Child's Name * First Middle Last
Enter your full name, including second and middle names.
Child's Goes by:
Child's Gender *

Child's Gender Female Male
Child's Birthday * / MM / DD YYYY
School Grade *
Upload a recent picture of your child

Attach Files Attach Files
Child's Cell Phone Number - ### - ### ####
Child's Email Address
List the schools your children attend
Middle School *
High School *
List full name and relationship of any close relatives you have who attend WHC (parents, grandparents, siblings, adult children, grandchildren, etc..)
Cultural Background Information
Languages you speak besides English

Enter languages you speak separeted by comma.
Where were you born? *
People Group & Ethnicity (Check all that apply) *
American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Hispanic or Latino
Religion Background and Spiritual Information
How did you hear about WHC? *
Have you been born again, receiving Jesus as your Lord and Savior? *

Have you been born again, receiving Jesus as your Lord and Savior? Yes No
Have you been Water Baptized? *

Have you been Water Baptized? Yes No
Have you received the Baptism in the Holy Spirit with the evidence of speaking in tongues? *

Have you received the Baptism in the Holy Spirit with the evidence of speaking in tongues? Yes No
Date * / MM / DD YYYY
I declare that the information provided in this form is true to the best of my knowledge. *

Clear
Draw your signature into the box.

WHC Next Step Class

WHC Next Step Class

Fields marked with * are required.

Personal Information

Contact Information

Family Information

First Child Info

Second Child Info

Third Child Info

Fourth Child Info

List the schools your children attend

Cultural Background Information

Religion Background and Spiritual Information