| OFFICE USE: MEMBERSHIP # ________
DATE w/Session ______________
w/Congregation ________________ Zone: ________________
|
FIRST PRESBYTERIAN CHURCH SPRINGFIELD, PA
NEW MEMBER FORM
(please print clearly)
___________________________________
LAST NAME ___________________________ ____________
FIRST MIDDLE
Mr.( ) Mrs. ( ) Miss ( ) Ms. ( )
ADDRESS _______________________________________
_____________________________________________
_____________________________________________
BIRTHDATE: _______________ Month/Day/Year
PHONE
NUMBERS: _________________________ ______________________ ________________
home cell work
(Please put a (U) next to any number you wish to be Unlisted or Unpublished or Unavailable)
OCCUPATION: ___________________________ E-MAIL: ______________
JOINING
BY: Confession or Reaffirmation of Faith ( ) Confirmation ( )
Transfer
of Membership ( ) from what church _____________________________________
_____________________________________
OTHERS
IN HOUSEHOLD SPOUSE/SIGNIFICANT OTHER (please circle one)
NAME: ____________________________ BIRTHDATE: _______________
Month/Day/Year
PHONE
NUMBERS: _______________________________ ____________________
Home cell work
(Please put a (U) next to any number you wish to be Unlisted or Unpublished or Unavailable)
OCCUPATION: ___________________________ EMAIL:__________________________
CHHILDREN
NAME: ____________________________ BIRTHDATE: _______________
Month/Day/Year
NAME: _____________________________ BIRTHDATE: _______________
Month/Day/Year
CHILDREN NOT LIVING AT HOME
NAME: _____________________________ BIRTHDATE: _______________
Month/Day/Year
NAME: ____________________________ BIRTHDATE: ________________
Month/Day/Year