1. New Member Information
Family Name:
Household Address:
Home Telephone:
Adult Male: Adult Female:
First Name: First Name:
Middle Name: Middle Name:
Preferred Name
(Nickname):
Preferred Name
(Nickname):
Suffix, Jr. Sr., II, etc.) Last Name (If
different.):
Membership Date: Membership Date:
Service Attended: Service Attended:
How came to
membership:
How came to
membership:
Transfer from: Transfer from:
Include on directory: Y / N Include on directory: Y / N
Birth date: Birth date:
Baptism date: Baptism date:
Work phone: Work phone:
Mobile phone: Mobile phone:
Work E-mail: Work E-mail:
Home E-mail: Home E-mail:
Messenger: E / USPS Messenger: E / USPS
Add to Church Chat Y / N Add to Church Chat Y / N
Sex: Sex:
Family relation: Family relation:
Racial/Ethnic
information:
Racial/Ethnic
information:
Shut In: Shut In:
Comments: Comments:
Groups/classes: Groups/classes:
Skills/interests: Skills/interests:
2. Child One: Child Two:
First Name: First Name:
Middle Name: Middle Name:
Preferred Name
(Nickname):
Preferred Name
(Nickname):
Suffix, Jr. Sr., II, etc.) Suffix, Jr. Sr., II, etc.)
Membership Date: Membership Date:
How came to
membership:
How came to
membership:
Transfer from: Transfer from:
Include on directory: Y / N Include on directory: Y / N
Birth date: Birth date:
Baptism date: Baptism date:
Home E-mail: Home E-mail:
Add to E-Messenger Y / N Add to E-Messenger Y / N
Add to Church Chat Y / N Add to Church Chat Y / N
Sex: Sex:
Family relation: Family relation:
Racial/Ethnic
information:
Racial/Ethnic
information:
Shut In: Shut In:
Comments: Comments:
Groups/classes: Groups/classes:
Skills/interests: Skills/interests: