New Member Information
Please fill out this form and click submit.
Household Last Name
Household Email
This address will receive a confirmation email
Household Type
Please select one option.
Adults Only
Adults & Children
Single Adult
Single Parent
Blended Family
Extended Family
Address
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Adult 1
Full Name
Maiden
Birthdate
Place of Birth
Cell Phone
Email Address
This address will receive a confirmation email
Marital Status
Date of Marriage
Have you been Baptised?
Please select one option.
Yes
No
Date & Location
Have you been Confirmed?
Please select one option.
Yes
No
Date & Location
Are you currently a member of another congregation?
Please select one option.
Yes
No
If yes, name and location of congregation
Will you be contacting for transfer information?
Please select one option.
I will
Please do so for me
Adult 2
Full Name
Maiden
Birthdate
Place of birth
Cell Phone
Email
This address will receive a confirmation email
Marital Status
Date of Marriage
Have you been baptised?
Please select all that apply.
Yes
No
Date & Location
Have you been confirmed?
Please select one option.
Option
Option
Option
Date & Location
Are you currently a member of another congregation?
Please select one option.
Yes
No
If yes, name and location of the congregation
Will you be contacting for transfer information?
Please select one option.
I will
Please do so for me
Adult 3
Full Name
Maiden
Birthdate
Place of birth
Cell Phone
Email
This address will receive a confirmation email
Marital Status
Date of Marriage
Have you been baptised?
Please select one option.
Yes
No
Date & Location
Have you been confirmed?
Please select one option.
Yes
No
Date & Location
Are you currently a member of another congregation?
Please select one option.
Yes
No
If yes, name and location of congregation
Will you be contacting for transfer information?
Please select one option.
I will
Please do so for me
Adult 4
Full Name
Maiden
Birthdate
Place of birth
Cell Phone
Email
This address will receive a confirmation email
Marital Status
Date of marriage
Have you been baptised?
Please select one option.
Yes
No
Date & Location
Have you been confirmed?
Please select one option.
Yes
No
Date & Location
Are you currently a member of another congregation?
Please select one option.
Yes
No
If yes, name and location of congregation
Will you be contacting for transfer information?
Please select one option.
I will
Please do so for me
Child 1
Name
Birthdate
Gender
Place of birth
Age
Current grade
Cell Phone
Email
This address will receive a confirmation email
Have they been baptised?
Please select one option.
Yes
No
Date & Location
Have they received 1st communion
Please select one option.
Yes
No
Child 2
Full Name
Birthdate
Gender
Place of birth
Age
Current Grade
Cell Phone
Email
This address will receive a confirmation email
Have they been baptised?
Please select one option.
Yes
No
Date & Location
Have they received 1st communion?
Please select one option.
Yes
No
Option
Date & Location
Have you been confirmed?
Please select one option.
Yes
No
Date & Location
Child 3
Full Name
Birthdate
Gender
Place of birth
Age
Currrent Grade
Cell Phone
Email
This address will receive a confirmation email
Have they been baptised?
Please select one option.
Yes
No
Date & Location
Have they received 1st communion?
Please select one option.
Yes
No
Date & Location
Have you been confirmed?
Please select one option.
Yes
No
Date & Location
Child 4
Full Name
Birthdate
Gender
Place of birth
Age
Current Grade
Cell Phone
Email
This address will receive a confirmation email
Have they been baptized?
Please select one option.
Yes
No
Date & location
Have they received 1st communion?
Please select one option.
Yes
No
Date & Location
Have they been confirmed?
Please select one option.
Yes
No
Date & Location
Submit
Description
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