MEMBER INFO SHEET

TODAY’S DATE:                      

FIRST NAME:                                   LAST NAME:

BIRTHDATE:

___ Profession of Faith

 ___ Requesting a Transfer Letter

BAPTIZED: Yes   No    DATE:

CHURCH NAME & CITY, STATE TRANSFERRING FROM (If applicable):

HOME ADDRESS:

EMAIL:

PHONE:

Mobile

OCCUPATION:

Home

HOW WOULD YOU PREFER TO BE CONTACTED? ___ Phone ___ Text Message ___ US Mail ___  Email

FIRST NAME:                                    LAST NAME:

BIRTHDATE:

___ Profession of Faith

 ___ Requesting a Transfer Letter

BAPTIZED: Yes   No    DATE:

PHONE:

Mobile

EMAIL:

Home

OCCUPATION:

HOW WOULD YOU PREFER TO BE CONTACTED? ___Phone ___Text Message ___Mail ___Email

WEDDING DATE (If applicable):

CHILD NAME

MEMBER

PREP. MEMBER

DATE OF BIRTH

DATE OF BAPTISM

WINTER MAILING ADDRESS

WINTER ADDRESS:

DATES:  FROM:   ____________  TO:  ____________

DATE RECEIVED INTO MEMBERSHIP:

DATE CERTIFICATE ISSUED:

DATE ENTERED IN SK:

DATE LETTER SENT: