Celebrate and share God's GRACE

New Member Form

First Name:


Middle Name:

Last Name:

Preferred Name:

Address-please include full address:

Home phone:

Cell phone:


Work phone:

Email:

Occupation:

Employer:

Birth date:

Birth place:

Baptized date:

Church where baptized:


City where church located:

State where church located:

Confirmed date:

Church were confirmed:

Marital status:

Wedding Date (if applicable):

Spouse’s information if applicable:
First Name:

Middle Name:


Last Name:


Preferred name:

Cell phone:

Work phone:

Email:

Occupation:

Employer:

Birth date:

Birth place:

Baptized date:

Church where baptized:

City:


State:

Confirmed date:

Church were confirmed:


City:


State:

Children’s information if applicable
Child 1-First Name:

Child 1-Middle Name:

Child 1-Last Name:


Birth date:

Baptized date:

Church were baptized:


Receives Holy CommunionConfirmed
Church where confirmed:

Grade in school:

Name of school:

Child 2-First Name:

Child 2-Middle Name:

Child 2-Last Name:


Birth date:

Baptized date:

Church were baptized:


Receives Holy CommunionConfirmed
Church where confirmed:

Grade in school:

Name of school:

Child 3-First Name:

Child 3-Middle Name:

Child 3-Last Name:


Birth date:

Baptized date:

Church were baptized:


Receives Holy CommunionConfirmed
Church where confirmed:

Grade in school:

Name of school:

Child 4-First Name:

Child 4-Middle Name:

Child 4-Last:


Birth date:

Baptized date:

Church were baptized:


Receives Holy CommunionConfirmed
Church where confirmed:

Grade in school:

Name of school:

Child 5-First Name:

Child 5-Middle Name:

Child 5-Last:


Birth date:

Baptized date:

Church were baptized:


Receives Holy CommunionConfirmed
Church where confirmed:

Grade in school:

Name of school: