St. Timothy's Membership Request Joining from a Non-Episcopal Church
Please complete this form and press Submit. The information provided here will be used by the staff and church members to communicate with you and for maintaining parish records.
Your name: *
Title, first, middle, last (please include maiden name in parentheses if applicable)
Your answer
The name you prefer to go by: *
Your answer
Your date of birth: *
(mm,dd,yyyy)
Your answer
Your gender: *
Marital status:
Street address including, City, State, Zip: *
Your answer
Preferred telephone number: *
Your answer
Email address: *
Your answer
Name of Non-Episcopal Church Last Attended
If applicable
Your answer
Date of your Baptism and date of your Confirmation:
If applicable
Your answer
Spouse's or other adult's name (if applicable)
Please include title, first, middle, last (including maiden name in parentheses if applicable)
Your answer
Spouse's/other adult's Goes by name, date of birth and gender:
example: Chris, 10/15/1969, male
Your answer
Spouse's/other adult's email address and a preferred telephone number:
Your answer
Name of Church Spouse Last Attended
Your answer
Date of spouse's/other adult's Baptism and date of spouse's/other adult's Confirmation:
If applicable
Your answer
Child 1 (if applicable)
Please include: Full Name (goes by name in parentheses); Gender; Date of birth; Date of Baptism & Church name (if applicable); and Anticipated year of high school graduation
Your answer
Child 2 (if applicable)
Please include: Full Name (goes by name in parentheses); Gender; Date of birth; Date of Baptism & Church name (if applicable); and Anticipated year of high school graduation
Your answer
Child 3 (if applicable)
Please include: Full Name (goes by name in parentheses); Gender; Date of birth; Date of Baptism & Church name (if applicable); and Anticipated year of high school graduation
Your answer
Child 4 (if applicable)
Please include: Full Name (goes by name in parentheses); Gender; Date of birth; Date of Baptism & Church name (if applicable); and Anticipated year of high school graduation
Your answer
Child 5 (if applicable)
Please include: Full Name (goes by name in parentheses); Gender; Date of birth; Date of Baptism & Church name (if applicable); and Anticipated year of high school graduation
Your answer
Child 6 (if applicable)
Please include: Full Name (goes by name in parentheses); Gender; Date of birth; Date of Baptism & Church name (if applicable); and Anticipated year of high school graduation
Your answer
Submit
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