LRPC Adult Membership Application

LRPC Adult Membership Application
This form is to be completed by all adults requesting membershp in this church. This information will be kept confidential, by the Session and Church Office, except for family and contact information shared in our Church Directory. Full dates are needed, but will not be published without your permission.
Date of Membership Application

MonthDayYear
Date of birth*

MonthDayYear
mm-dd-yyyy - The year will not be published
Nickname
Called by name, abbreviation, alias
Full Legal Name:
Title:
select one:
Legal Name*

First NameMiddle Name(s)Last NameMaiden Name, or Suffix - Jr. Sr, III)
Home Address
Address*

Street Address

Line 2

CityState Code

Zip Code
Your Contact Information:
Home Phone
Cell Phone
Email twice*

Confirmation Emailexample@example.com
How did you learn about our church?
Current / Previous Church Membership
Are you currently a member of another Church*

YesNo
Name of the Church
Church Address

Line 1

Line 2

CityState Code

Zip Code
Church Phone
Phone Number
Church Email
example@example.com
Reason for leaving
Baptized*

YesNo
Where
Date or Age baptized
Employer:
Name of Organization
Your Occupation
Work Address

Line 1

Line 2

CityState Code

Zip Code
Your Work Phone
Other Phone or FAX
Your Work Email
example@example.com
Immediate Family (at home) Information. If both husband and wife are submitting an application together, the following information is only required once.
Marital Status & Spouse:
Maritial Status*

SingleMarried
Date of Marriage

MonthDayYear
The year will not be published
WidowedSeparatedDivorced
Spouse's Legal Name

First NameMiddle Name(s)Last NameMaiden Name, or Suffix - Jr. Sr, III
Spouse Date of Birth

MonthDayYear
mm-dd-yyyy -The year will not be published
LRPC Member?

YesNo
1st Child
Child's Name

First NameMiddle NameLast Name if differentSuffix - Jr. II,
Date of Birth

MonthDayYear
mm-dd-yyyy -The year will not be published
Male or Female

MaleFemale
LRPC Member?

YesNo
2nd Child
Child's Name

First NameMiddle NameLast Name if differentSuffix - Jr. II,
Date of Birth

MonthDayYear
mm-dd-yyyy -The year will not be published
Male or Female

MaleFemale
LRPC Member?

YesNo
3rd Child
Child's Name

First NameMiddle NameLast Name if differentSuffix - Jr. II,
Date of Birth

MonthDayYear
mm-dd-yyyy -The year will not be published
Male or Female

MaleFemale
LRPC Member?

YesNo
Additional Children

add to Spouse's application / or ask for an addendum
TO BE COMPLETED BY THE CHURCH

after a Membership Interview w/Session
Membership by:
Date

MonthDayYear
Date
Transfer from:
Offering Number
Shepherding Elder:
LOCH RAVEN PRESBYTERIAN CHURCH

Page 2 for the Trustee Committee
TALENTS/INTERESTS SURVEY Select all that apply
Legal Name*

First NameMiddle Name(s)Last NameMaiden Name, or Suffix - Jr. Sr, III)
Phone Number
Sunday School

Teaching RegularlyTeaching SubstituteNursery AttendantAll YouthAdultOther
Outreach Ministry

Friendly GreeterShare TestimonyShare ChristOther
Couple Activities

Marriage BuildersHome Bible StudyOther
Media Team

Sound SystemComputer ProjectionPowerPointWebsiteLibraryOther
Office Help

Advertising / Marketing
list here
Arts Hobbies Crafts

Yes
list here
Other Not Listed

Yes
list here
Worship & Music

ChoirPraise TeamOrchestraSoloist Vocal / InstrumentalChildren's Church LeaderChildren's Church HelperOther
Prayer Team

Tuesday 1-2 pmOther
Men's Ministry

UsheringBreakfast Host/AttendDinner Host/AttendOther
Women's Ministry

Women in the ChurchCircle (Bible Study)Exercise GroupOther
Care / Share

Home VisitationVisit Shut in/ElderlyDivorce MinistryTOPSOther
Handyman

Lawn / GardenCarpentryHVACElectricalPlumbingOther
Youth

Teacher / LeaderHelperChaperoneTransportationAll GradesYouth For ChristPuppet / DramaVBSOther
Young Adults

Singles GroupCollege / CareerOther
Senior Fellowship

ROMEOJULIETOther
Missions

ConferenceShort-term Trip
Discipleship

Home-basedWorship ServiceOther
Fellowship

Event Planner / CoordinatorKitchen WorkersHost Home DinnersKnitting GroupOther
Talent Comments / Questions
Any FORM usage Issues / Comments
LOCH RAVEN PRESBYTERIAN CHURCH
Should be Empty:

LRPC Adult Membership Application

Full Legal Name:

Home Address

Your Contact Information:

Current / Previous Church Membership

Employer:

Immediate Family (at home) Information. If both husband and wife are submitting an application together, the following information is only required once.

Marital Status & Spouse:

1st Child

2nd Child

3rd Child

Additional Children

TO BE COMPLETED BY THE CHURCH

LOCH RAVEN PRESBYTERIAN CHURCH