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:*

Clear

$65 Membership Fee*

Will be included with the printed formPay Online (see below):

You can pay for your membership on-line using the secure Square Portal

Annual MembershipMembership is per individual

$65.00

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

Credit Card

OFFICIAL CHURCH USE ONLY