Membership Application Form

Thank you for taking the time to complete this online Membership Application. If you have any question about this form, please contact our Office Administrator, . As soon as we receive your competed form, we will contact you as soon as possible about next steps. Thank you for your interest in becoming a Member at Roser!

Wish to join Roser as:(Required)
Local Address(Required)
Alternate Address (if applicable)
Check box or text ROSER to 22828
MM slash DD slash YYYY
MM slash DD slash YYYY
Would you like us to order a Name Tag for you?(Required)
Would you like to be included in our church directory?(Required)
Would you like to submit a photo to be included in the church directory.(Required)
If you answer “yes” to this question, please email your photo to Thank you.
This field is for validation purposes and should be left unchanged.