Membership We’re delighted you’re taking the first step in membership.Please complete the form below and we’ll get back to you soon. Why should I become an Episcopalian? Name * First Name Last Name Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Date of Birth * MM DD YYYY Home Phone (###) ### #### Cell Phone * (###) ### #### Your Profession * Work Phone (###) ### #### Church History Have you been baptized? * Yes No If you were baptized, where were you baptized? If you were baptized, when were you baptized? MM DD YYYY Are you a member of an Episcopal church? * Yes No If yes, name of the Episcopal church and city If you answered yes, please indicate the name of the church and city and a Letter of Transfer will be completed to St. Francis. Have you been confirmed? * Yes No If yes, where and on what date were you confirmed? Marital Status * Single Married Widowed Divorced N/A Wedding Date (if applicable) MM DD YYYY Name of Church Where Married (if applicable) Spouse Name (if applicable) First Name Last Name Spouse Email Address (if applicable) Spouse Date of Birth (if applicable) MM DD YYYY Spouse Phone Number (if applicable) (###) ### #### Is your spouse baptized? (if applicable) Yes No If yes, when was your spouse baptized? (if applicable) MM DD YYYY Where was spouse baptized? (if applicable) Is your spouse a member of an Episcopal church? (if applicable) Yes No If yes, name of spouse's Episcopal church and city Was spouse Confirmed? (if applicable) Yes No if yes, where and on what date was spouse confirmed? (if applicable) When was your spouse confirmed? (if applicable) MM DD YYYY Spouse's Profession (if applicable) Emergency Contact * First Name Last Name Emergency Contact Phone * (###) ### #### OK to send Emergency Contact SMS Text Messages? Yes No Areas of Interest Please select all of the following that interest you or any members of your household. Opportunities for Involvement Altar Guild Accolytes Assisi Choir Bell Choir Lay Eucharistic Ministry Lay Reader/Chalice Bearer Outreach Teaching Sunday School Ushering Youth Group Areas of Interest Arts/Crafts Baking/Cooking Bible Study DIY/Repair Work Gardening Photography Sports/Athletics Technology Additional Comments Children Please complete the next portion only for children living at home or who are still in college. Number of Children Child 1 Name First Name Last Name Goes by name Date of Birth MM DD YYYY Cell Phone (###) ### #### Email Baptized Yes No If yes, where was your child baptized? Church name If yes, when was your child baptized? MM DD YYYY School Current Grade Pre-Kindergarten Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 College / University N/A Child 2 Child 2 Name First Name Last Name Goes By Name Date of Birth MM DD YYYY Cell Phone (###) ### #### Email Baptized Yes No If yes, where was your child baptized? Church Name If yes, when was your child baptized? MM DD YYYY School Current Grade Pre-Kindergarten Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 College / University N/A Child 3 Child 3 Name First Name Last Name Goes By Name Date of Birth MM DD YYYY Cell Phone (###) ### #### Email Baptized? Yes No If yes, where was your child baptized? If yes, when was your child baptized? MM DD YYYY School Current Grade Pre-Kindergarten Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 College / University N/A Thank you! Someone from the church will be in touch with you soon.
