Worthington Presbyterian Church Members and Friends: Staying Current, Staying Connected, Making a Difference
Periodically, any database needs a careful review for accuracy. The larger the congregation, the larger the need. We are asking all members and friends of WPC to complete this form, so we may review and update our data. Individual information is used by and for WPC ministries and is not shared or sold, except for aggregate demographic information required for the denomination's annual statistical report.

Outcomes of this project will include:

-- Updated Membership Directories (in both print and password--protected online version)- providing address, phone, and email information

-- Better organization for pastoral care and for ministry to people at all ages and life stages

-- Demographic Information (marital status, race/ethnicity, disability, etc.) required for the PC(USA) annual report

-- A chance to tell us what kind of communication you would like to receive from us

Instructions- Complete one form per adult (there is a submission button at the end of this update). Please direct any questions to Lori Sheppard, Membership Clerk, at lsheppard@worthingtonpresbyterian.com or call 614-885-5355. Thank you for helping us, and for helping us to help YOU.
Membership- Are you a:
First name
Your answer
Middle Name
Your answer
Last name (included hyphenated names)
Your answer
Suffix (Jr., Sr., III, IV, etc. -- if applicable)
Your answer
Street address
Your answer
Apartment or unit number (if applicable)
Your answer
City
Your answer
State
Your answer
ZIP code
Your answer
Home or Primary phone number (format: xxx-xxx-xxxx)
Your answer
Is this a cell phone number?
Secondary phone number
Your answer
Is this a cell phone number?
Primary email
Your answer
Which of the following communications would you like to receive via e-mail?
Date of birth
MM
/
DD
/
YYYY
Gender
Current profession & employer
Your answer
Previous profession & employer (If retired or on a second career)
Your answer
If you have a disability, please select all that apply.
Do you require handicap parking?
Race / ethnicity (select all that apply)
Please list children (full names and ages) living at home, if applicable.
Your answer
Relationship status
Date of marriage (if applicable)
MM
/
DD
/
YYYY
If widowed, date of spouse's death (for pastoral care)
MM
/
DD
/
YYYY
Highest level of education completed
High school attended (include city and state)
Your answer
College attended (undergrad) (include city and state)
Your answer
College attended (advanced/professional degree) (include city and state)
Your answer
Please share any talents or skills you wish to use for WPC ministries (e.g. photography, hospitality/ cooking, writing, gardening, driving, etc.)
Your answer
Thank you for your time and effort, which will help us stay better-connected as a congregation. God bless you!
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