Membership information

Please complete one form per person.

Name

First Name

Last Name

Preferred name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

If you live in one of the developments, please provide the development name:

(e.g. Sun Ridge off Voorhees Corner Rd.)

Preferred Phone

(###)

###

####

Preferred Phone Type (for the number provided above)

Email Address

Can we publish the above information in our church directory?

(Name, address, phone, and email address)

Yes

Choose one

Spouse's name (if applicable)

First Name

Last Name

Birthdate (please include year)

YYYY

Wedding anniversary (if applicable)

YYYY

Occupation and Employer

Hobbies and Interests

I have been baptized

Yes

I will be received by:

(if you are unsure, please contact the church office)

If you will be received by Certificate of Transfer, please list the name and address of the church from which you are transferring:

In my former church, I served as a:

Date of ordination

YYYY

Please list other areas of participation:

(church choir, youth group leader, etc.)

If applicable, please list the names and birthdates of your dependent children

If applicable, please list the date and church of your children's baptisms

Membership information

Address

Contact

Schedule