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St. Luke's Membership Form
Thank you for your interest in joining St. Luke's Episcopal Church! The completion of this form is the first step towards joining the church. Please fill out the information as accurately as possible. We will be in touch very soon after your form is submitted. If you have any questions, please call the church office at (225) 926-5343 or email us at
stlukesbrchurch@gmail.com
.
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SECTION 1: PERSONAL INFORMATION
Full Name
*
Your answer
Date of birth
*
MM
/
DD
/
YYYY
Street address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip code
*
Your answer
Phone
*
Your answer
Is the above number a...
*
mobile phone
home phone
work phone
Other:
Alternate Phone
Your answer
Is the above number a...
mobile phone
home phone
work phone
Other:
Clear selection
Email
*
Your answer
Marital Status
*
Single
Married
Divorced
Widowed
Family Position
*
Head
Spouse
SECTION 2: CHURCH RECORD INFORMATION
Have you been baptized?
*
Yes
No
No, but I'm interested in learning more about baptism
If yes, please provide the date of your baptism, along with the name, denomination, and city/state location of the church.
Your answer
Have you been confirmed in an Episcopal church?
*
Yes
No
No, but I'm interested in learning more about confirmation
If yes, please provide the date of your confirmation, along with the name and city/state location of the church.
Your answer
If transferring membership from a previous church, please provide that church's name, denomination, and city/state location.
Your answer
SECTION 3: SPOUSE/PARTNER INFORMATION
Is your spouse/partner joining St. Luke's, too?
*
Yes
No
N/A
Spouse's full name
Your answer
Spouse's date of birth
MM
/
DD
/
YYYY
Spouse's phone number
Your answer
Spouse's email
Your answer
Spouse's baptism information (date, denomination, church name and location)
Your answer
Spouse's confirmation information (date, denomination, church name and location)
Your answer
SECTION 4: CHILDREN LIVING IN SAME HOUSEHOLD
1) First child's full name
Your answer
First child's date of birth
MM
/
DD
/
YYYY
First child's baptism information (date, denomination, church name and location)
Your answer
First child's confirmation information (date, denomination, church name and location)
Your answer
2) Second child's full name
Your answer
Second child's date of birth
MM
/
DD
/
YYYY
Second child's baptism information (date, denomination, church name and location)
Your answer
Second child's confirmation information (date, denomination, church name and location)
Your answer
3) Third child's full name
Your answer
Third child's date of birth
MM
/
DD
/
YYYY
Third child's baptism information (date, denomination, church name and location)
Your answer
Third child's confirmation information (date, denomination, church name and location)
Your answer
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