Your Name (required)
Date of Birth (required)
Your Email (required)
Have you accepted Christ as your savior? (required)
If you are “Born Again” how do you know that you are? (required)
Are you married? (required)
Name of spouse
Do you ingest alcoholic or any addictive substances?
Do you renounce any involvement with the occult?
As a member of Destiny, do you commit to living your life according to
the biblical standards that are outlined in the Holy Bible
Do you commit to submitting to the Pastor and leaders of Destiny?
Will you recognize leadership and Board as the final authority for discipline and correction here at
Please check the appropriate options:
A. I desire to be Water Baptized Yes
B. I am applying for Membership Yes