Membership Information Form
Name (First, Middle, and Last):
Your answer
Email:
Your answer
Home Address:
Your answer
Home Phone:
Your answer
Cell Phone:
Your answer
Work Phone:
Your answer
Have you been ordained in the PCUSA as a:
Occupation/Retired/Student
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Name of Employer/Firm/School
Your answer
Birthday:
MM
/
DD
/
YYYY
Marital Status
Spouse/Partner's Name
Your answer
Date Married
MM
/
DD
/
YYYY
Children's Names
Your answer
Request To Unite With Grace Covenant Church By: (There are 4 ways to join a Presbyterian Church, please choose the one that best pertains to you. And if you have any questions, you can always contact one of the pastors.):
If transferring membership, what is the name and address of your former church?
Your answer
If applicable, what age were you baptized?
Your answer
Service in former churches:
Your answer
Interests and Hobbies:
Your answer
Name(s) of members of Grace Covenant with whom you are acquainted who could be invited to help in your orientation as a new member:
Your answer
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