Membership Application

Contact info: (503) 656-9144 | info@oregonarmenianchurch.com

(please submit and pay online, or print and provide physical payment of $65)

TODAY'S DATE:*

Date

Name*

First NameLast Name

Phone Number (Mobile)

Please enter a valid phone number.

Phone Number Home)

Please enter a valid phone number.

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Renewing a membership?*

YesNo (I am a new member)

Birth Date

Date

Birth Place:

Baptism Date:

Date

Baptism Church:

Baptism Location:

Wedding Date:

Date

Occupation:

Skills:

Would you like to receive the Diocesan Newsletter

YesNo

I hereby apply for membership in the St. Kevork Armenian Apostolic Church of Portland, Oregon, and I attest that I have been baptized and/or Chrismated in the Armenian Church, and that I accept the doctrines, hierarchical authority, cannons, and rites thereof, and thatI am not a member of another church. I promise to attend church, and faithfully fulfill my obligations to the church and to adhere to the By-Laws of the Western Diocese of the Armenian Church of North America. I also understand that any information that I have provided here may be used by the Diocese for their record keeping and for communication with parishioners.

Signature:*

$65 Membership Fee*

Pay Online (see below):

You can pay for your membership on-line, or pay in person. Starting 2024 you can subscribe for recurring payments billed annually.

Annual MembershipMembership is per individual, billed annually if you subscribe to recurring payments. Number of years (recurring payments)can be controlled using the drop down menu below.

$65.00 for each year

Recurring payments

Enter coupon

Total

$0.00

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Credit Card

APPROVED BY

SIGNED BY

St. Kevork Armenian Church, 9215 SE Church Street, Clackamas, OR 97015

Membership Application

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OFFICIAL CHURCH USE ONLY