Join us for worship, Sundays at 10:00AM at 4310 Pleasant Valley Rd, Chantilly, VA 20151
Making Christ Known in Northern Virginia

Membership Application – OLD Version

Please download, fill out and return the Membership Covenant PDF form.

Adobe pdf_iconMembership Covenant Form

Adobe pdf_icon Membership Manual

Or fill out the form below the covenant agreement and click Send

In order to become a member, a candidate for membership enters into this covenant agreement with Shepherd Gate Church which includes the following:

  1. BELIEF that Jesus Christ is the son of God and has received Him as my Lord and Savior
  2. UNDERSTANDING that I am responsible to follow the teaching of God’s Word and to live my life in such a way that it brings honor to God and credit to the Body of Christ
  3. UNDERSTANDING that I am to be a loyal and supporting member of this congregation and will do so with my presence, prayers, helps, tithes, and offerings
  4. UNDERSTANDING that as a member in good standing, I am entitled to attend and vote at congregational meetings and to raise concerns and interests with the Elders of the Church
  5. AGREEMENT to invite the care and concern of the Elders and the members of the congregation for my life and will receive counsel from them when necessary
  6. AGREEMENT that I have read the Constitution and Bylaws, including but not limited to those policies dealing with the Church discipline, conflict resolutions, member’s rights and responsibilities, and holy covenant, and agree to be bound by the Constitution and Bylaws and accompanying policies and procedures

Application for Membership


Your Name (required)

Your Email (required)

Address (required)

Home Phone Number (not required but very useful)

Work Phone Number(Optional)

Date of Birth(Optional)

Marital Status (Optional)

If this is a Joint Application:

Name of Spouse

Date of Marriage(Optional)

Spouse Birthday(Optional)

Spouse Phone Number(Optional)

Spouse Email(Optional)

Children's Names and Birthdays(Optional)

Are you moving your membership from a previous Church?(Optional)

Name and address of previous Church(Optional)

Name of Pastor or Priest(Optional)

List Ministries and Church offices in which you have served.(Optional)


Required Fields


I will protect the unity of my church: (required)

by acting in love toward other members,

by refusing to gossip

by following its leadership, Constitution, and Bylaws.


I will share in the responsibility of my church: (required)

by praying for its growth and love for God

by inviting the unchurched to attend, and

by warmly welcoming those who visit.


I will serve the ministry of my church: (required)

by discovering my gifts and talents,

by seeking to grow into the image of Christ to serve Him, and

by developing a servant’s heart.


I will support the testimony of my church: (required)

by attending faithfully,

by living a Godly life and

by giving regularly.


I acknowledge that I meet the requirements for membership: (required)

by having made Jesus Christ my personal Lord and Savior,

by having been baptized by immersion, and

by having attended Shepherd Gate Church for at least two months.

If you have selected all of the required fields above then Clicking on “Send” will serve as your affirmation to the above requirements and convictions that we hold as members of this congregation.


Preferred method of response to this membership request:


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We also encourage you to sign up for our newsletter.
This form has purposefully been narrowed to make filling this out easier for those with portable devices.