Name:
Address (street, city, zip): Email:
Phone (work): (home)
Cell phone(s):
Birthdate (mmddyy):
Children (names, ages):
Have you been baptized in any Christian church? yes no
If your answer is "yes," in what church were you baptized and when? Baptized: When: (If you have not been baptized, then you will join the church through adult baptism. Pastors Dan, Todd or Lynne will need to meet with you. Please call and arrange a time.)
Are you currently a member of another church? yes no (If your answer is "yes," please provide complete information about the church and yourself so that we can send for a letter of transfer.)
Church name: Address (street, city, zip): Phone: Email: By what name does this church know you? (If you have been baptized and are not a member of another church then you will come into membership by reaffirmation of faith.)
Church name: Address (street, city, zip):
Phone: Email:
By what name does this church know you?
(If you have been baptized and are not a member of another church then you will come into membership by reaffirmation of faith.)
Have you served as a deacon or elder in the Presbyterian Church? yes no