New Members
About Your Household
Head of Household #1
*
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Family E-Mail
*
example@example.com
Family Home Phone
*
Please enter a valid phone number.
Do you have a spouse or significant other joining with you?
*
Yes
No
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Next
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
What describes you best:
*
Single
Widowed
Married
Significant Other
Male
Female
Date of Marriage
-
Month
-
Day
Year
Date
Church & City, State of Marriage
Date of Birth
*
-
Month
-
Day
Year
Date
Place of Birth
*
Date of Baptism (if known)
Church & City, State of Baptism (if known)
Date of Confirmation (if known)
Church & City, State of Confirmation (if known)
Place of Employment
Occupation
Joining St. Philip the Deacon by:
*
Affirmation of Faith
Church Transfer
If church transfer: Enter the name of the church and the city where it's located
Head of Household #2
First Name
Middle Name
Last Name
Male
Female
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
Place of Birth
Date of Baptism (if known)
Church & City, State of Baptism (if known)
Date of Confirmation (if known)
Church & City, State of Confirmation (if known)
Place of Employment
Occupation
Joining St. Philip the Deacon by:
*
Affirmation of Faith
Church Transfer
If church transfer: Enter the name of the church and the city where it's located
Back
Submit
Add a Child
Children Joining with You
Name
First Name
Middle Name
Last Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
City, State of Birth
Check all that apply:
My child is baptized.
My child is confirmed.
Date of Baptism (if known)
Church, City & State of Baptism
Date of Confirmation (if known)
Church / Place of Confirmation
Current Grade
Please Select
Not Applicable
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Projected Year of High School Graduaton
Back
Submit
Add Another Child
Children Joining with You
Name
First Name
Middle Name
Last Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
City, State of Birth
Check all that apply:
My child is baptized.
My child is confirmed.
Date of Baptism (if known)
Church, City & State of Baptism
Date of Confirmation (if known)
Church / Place of Confirmation
Current Grade
Please Select
Not Applicable
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Projected Year of High School Graduaton
Back
Submit
Add Another Child
Children Joining with You
Name
First Name
Middle Name
Last Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
City, State of Birth
Check all that apply:
My child is baptized.
My child is confirmed.
Date of Baptism (if known)
Church, City & State of Baptism
Date of Confirmation (if known)
Church / Place of Confirmation
Current Grade
Please Select
Not Applicable
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Projected Year of High School Graduaton
Back
Submit
Add Another Child
Children Joining with You
Name
First Name
Middle Name
Last Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
City, State of Birth
Check all that apply:
My child is baptized.
My child is confirmed.
Date of Baptism (if known)
Church, City & State of Baptism
Date of Confirmation (if known)
Church / Place of Confirmation
Current Grade
Please Select
Not Applicable
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Projected Year of High School Graduaton
Submit
Should be Empty: