After you submit this form, please complete the “Time and Talents” form and submit that as well. Thank you. Today's Date * MM DD YYYY Gender * Male Female First * Middle Last * Please note any preferred nickname. Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email Address Cell Phone (###) ### #### Home Phone (###) ### #### Work Phone (###) ### #### Date of Birth * MM DD YYYY Place of Birth * Date of Baptism MM DD YYYY Baptism Sponsors Place of Baptism Date of Confirmation MM DD YYYY Place of Confirmation Current Church Membership Date of Marriage MM DD YYYY Place of Marriage Name of Spouse (First, Middle, Maiden and Last Name) Spouse's Birthday MM DD YYYY Complete Name of Parents * Maternal Grandparents * Paternal Grandparents * Name of Children and Date of Birth Occupation Employer Elementary Schools Attended High School Attended Postsecondary School (if applicable) Highest Grade Completed 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 At baptism, I have been a sponsor or godparent for: Sponsor/s for Membership * In discussion with Pastor First Name Last Name My favorite Bible passage My favorite hymn Thank you for your time.
