Membership Application

Contact info: (503) 656-9144 | info@oregonarmenianchurch.com
Membership Application
(please submit and pay online, or print and provide physical payment of $50)
TODAY'S DATE: *

Month Day Year
Date
Name *

First Name Last 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

City State / Province

Postal / Zip Code
Occupation:
Skills:
Would you like to receive the Diocesan Newsletter

Yes No
Renewing a membership? *

Yes No (I am a new member)
Birth Date

Month Day Year
Date
Birth Place:
Baptism Date:

Month Day Year
Date
Baptism Church:
Baptism Location:
Wedding Date:

Month Day Year
Date
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
$50 Membership Fee *

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

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

Annual Membership Membership is per individual

$ 50.00

Total

$ 0.00