individual member profile

ADVENT INDIVIDUAL MEMBER PROFILE

This information will be confidential to Advent Administration
Date

MonthDayYear
Date
Last Name
First Name
Name Tag Information:

First NameLast Name
Name Tag Preference: Magnet or Pin?
Order pin if you have a Pacemaker, Internal Defibrillator or insulin Pump.
Local Address
Street Address
City/State/Zip
Cell Phone #
Format: (000) 000-0000.
Home Phone #
Format: (000) 000-0000.
Email Address
example@example.com
Include you in our Church directory?
Alternate Address
Street Address
City/State/Zip
Dates there: From
Month
To
Month
Birthday:

MonthDayYear
Date
Anniversary:

MonthDayYear
Date
Date baptized, if known

MonthDayYear
Date
Date confirmed, if known

MonthDayYear
Date
If registered in another Episcopal Church, please complete:
Name of church
Street Address
City / State / Zip
NOTE: If you wish to transfer your church membership to Advent Episcopal Church, please check here:
How did you hear about Advent?
Please list your skills or areas of interest that may benefit the mission of Advent Church:
After you complete your form and hit Submit, please choose "Send pdf as email" and enter information@adventaz.org
Should be Empty:

Local Address