St. Mary & St. Mercurius Church of Conshohocken Membership
This form is for a whole family including children up to 18 years old. Please take your time to fill the form accurately to your knowledge, starting by the husband if possible. Persons 18 and above, please fill a separate form.
Email address *
Given Name *
Your answer
Family Name *
Your answer
Gender *
E-mail 1 - Value *
Your answer
Phone 1 - Value *
Your answer
Birthday *
MM
/
DD
/
YYYY
Address 1 - Street *
Your answer
Address 1 - City *
Your answer
Address 1 - Region *
Address 1 - Postal Code *
Your answer
Occupation *
Your answer
Primary Church *
Secondary Church
If any.
Your answer
Father of Confession *
Your answer
Are You a Deacon?
If yes, please choose the rank from the following.
Are You a Sunday School Servant?
If yes, please choose the sector from the following.
Other Involvement in the Church
Choose all services that you CURRENTLY participate in
Which service(s) you would like to participate in?
Choose all services that you WOULD LIKE to participate in
Can You Play A Musical Instrument?
If yes, please list the instrument(s) that you can play (comma separated).
Your answer
Special Needs (Per Family) *
Church wants to know if there is a member of the family with a chronic health issue, disabled, if there is a marital problem, or any issue that they want the priest to be involved. A YES answer will be followed by a phone call from Fr. Andrew for more clarification. All info will remain completely confidential.
Married? *
Notes
Your answer
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This form was created inside of St Mary and St Mercurius Coptic Orthodox Church of Greater Philadelphia.