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Members Data Collection Form

This form is highly confidential. Information entered here is strictly for Admin & Pastoral purposes. Confidential information shall not be divulged to any third party.

Personal Data
Please enter your first name.
Please enter your surname.
Please enter your phone number.
Please enter your email address.
Please choose your gender.
Please choose your marital status.
Date of Birth:

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Please enter your date of birth.
Please enter your residential address.
Neighbourhood/Nearest Landmark
Please choose your neighbourhood or nearest landmark to your home.
Please upload a clear photo of your face.
CITH (Church in the Home)
n/b: It is a requirement for every member to belong to a CITH group. Kindly select the CITH closest to your address. Note the address and contact and kindly reach out to your CITH.
Bridge of Hope CITH
Address: Block 1, flat 2, Central Police Barracks, Opposite Aggrey Road.
Coverage Area: Aggrey Road, Town, Old GRA
Leader's Phone No.: 08037909690

Daystar CITH
Address: 10, Chinemerem Street, Location 15, Umuebule2, Etche LGA.
Coverage Area: Oyigbo
Leader's Phone No.: 08036868925

Delight Ville CITH
Address: 18, Farm Road, Beside Ben Worseley Furniture, Off Ada George, Port Harcourt.
Coverage Area: Ada George
Leader's Phone No.: 08062135617

Divine Favour CITH
Address: 3 Church close beside Redeemed Christian Church, Between UBA & GTB, YKC Woji.
Coverage Area: Woji, Elelewon and Akpajo
Leader's Phone No.: 08066263225

Faith Arena CITH
Address: 9, Main Street, Farm Road 2 Estate, Eliozu, Port Harcourt.
Coverage Area: Eliozu, Rumuokoro, Rumuodumaya, Rupokwu, Rukpakwulusi.
Leader's Phone No.: 07030747171

Fount of Love CITH
Address: 5, Chief Kingdom Ogunka Street, Off Farm Road, Rumuewhara, New Layout, Port Harcourt.
Coverage Area: Rumhuewara, Eneka
Leader's Phone No.: 08063260965

Fruitful Vine CITH
Address: Fruitful Vine 5b Wonodi Street, Off Olu-Obasanjo Road.
Coverage Area: GRA Phase 3, Olu Obasanjo, Waterlines
Leader's Phone No.: 08027755026

Glory Reign CITH
Address: 9 Onowu Street, Opposite Maggie Memorial Hospital, NDDC Road, Iwofe.
Coverage Area: Iwofe, NTA Road, Agip, Wimpey
Leader's Phone No.: 08063513001

Green Pastures CITH
Address: A&G Montessori School, Presidential Estate off Presidential Bus Stop, Aba road.
Coverage Area: Aba road, MummyB Road Elekahia, Stadium road Rumukalaghor, Rumuola Rumuomasi, Rumuobiakani
Leader's Phone No.: 08057364026

Greenfield CITH
Address: Jonah Onukem Street, Off Okporo Road Rumuodara.
Coverage Area: Rumudara, Eliohani, Rumuwhara
Leader's Phone No.: 08063339916

Greenspring CITH
Address: 7 Gboms Avenue, off Sani Abacha Road GRA 3.
Coverage Area: GRA Phase 3, 2, Waterlines, Agip
Leader's Phone No.: 08033975935

Heritage CITH
Address: Life Live Estate Owhor Close, Oroazi.
Coverage Area: Orazi, Rumuokwuta, Rumuola, Rumueme, Rumuigbo and Rumepirikom
Leader's Phone No.: 08038688497

Hill City CITH
Address: 8B Begonia Close, Trinity Gardens Estate, Igbo-Etche Road.
Coverage Area: Rumukwurushi, Eleme Junction, Igbo Etche Road
Leader's Phone No.: 08080543294

Jireh CITH
Address: 1 Chief Jack Close, Doxa Road, off Peter Odili Road.
Coverage Area: Peter Odili Road, Abuloma
Leader's Phone No.: 08068853913

Lighthouse CITH
Address: 5, Peace Estate, RD Road, Off Okporo Road, Artillery, Port Harcourt.
Coverage Area: Okporo Road, 1st&2nd Artillery, Shell RA, Tank, Rumukwurushi
Leader's Phone No.: 08063671296

New Wine CITH
Address: 2, Oriebe Street, Rumuokani New Layout, Opposite Dominion City Church, NTA Road, Mgbouba, Port Harcourt.
Coverage Area: Mgbuoba, NTA Road
Leader's Phone No.: 08034422517

Oasis CITH
Address: 4, Agudama Street, D/line, PH.
Coverage Area: D Line, Ikoku, Fruits Garden
Leader's Phone No.: 08106376250

Potters Treasure CITH
Address: House on the Rock, Port Harcourt
Coverage Area: For Choir Members
Leader's Phone No.: 08038866222

Redeeming Love CITH
Address: Flat 15 Michelin Estate, woji Railway.
Coverage Area: Woji, Rumuibekwe/Rumurolu, Woji Railway, Elijiji, Mangroove, Woji Junction
Leader's Phone No.: 09010121463

Springfield CITH
Address: Road 3, No. 8A Agip Estate.
Coverage Area: Agip Estate, Mgbuishimini, Chinda, Nsirim Rd, Ada George (Agip to pepperoni junction), Miles 1,2,3&4 axis of Ikwerre Rd.
Leader's Phone No.: 08035529025

Treasure CITH
Address: Plot 52 Sir Collins Owhonda Close, Eagle Island.
Coverage Area: Eagle Island, Mile 1, Mile 3, Diobu
Leader's Phone No.: 08069104370

Wellspring CITH
Address: No 8 Ohiamini Crescent by Rumuola new road off Psychiatric Road.
Coverage Area: Psychiatric Road, Rumuomoi, Rumuorosi, New Rumuola Road and Rumuigbo Junction.
Leader's Phone No.: 08038416479

None (I live outside Port Harcourt)
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Occupation Data
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Faith-based Data
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House on the Rock Academy Data
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House on the Rock Workforce Data
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By submitting this form, I confirm that I have crosschecked my entries and all my information contained herein are true and have been correctly entered.