Membership Renewal Form

By filling out this form, you are affirming that you have remained a member in good standing of Elmira Pentecostal Assembly during the year of  2021, and wish to retain your membership in 2022. You also affirm that you understand and agree with the basic responsibilities and privileges that are assumed with this membership.

Has your address or phone number changed in the last year? If yes please fill out the information below.

Thank you for taking the time to renew your church membership!