St. James Episcopal Church

Ancient Worship. . .Open Minds. . .
Come Inside. . .Make a Difference

Katherine B. Moorehead, Rector

Parish Information

This form may be used for New Members and Existing Members.

New Members: Please complete all information for your church records.

Existing Members: Please complete ONLY the areas where changes are needed.

Thank you!

Choose one: New Member Existing Member Changes

FAMILY ADDRESS INFORMATION

Family Name

Street Address Apt/Lot Number

Mailing Address

City State Zip

Home Phone Family Email Address

HUSBAND

WIFE

Name

Occupation

Wedding Anniversary

Cell Phone

Birthday

Baptism Date

Confirmation Date

Name

Occupation

Maiden Name

Cell Phone

Birthday

Baptism Date

Confirmation Date

CHILD 1

CHILD 2

Name

Birthday

Baptism Date

Confirmation Date

Name

Birthday

Baptism Date

Confirmation Date

CHILD 3

CHILD 4

Name

Birthday

Baptism Date

Confirmation Date

Name

Birthday

Baptism Date

Confirmation Date

CHILD 5

CHILD 6

Name

Birthday

Baptism Date

Confirmation Date

Name

Birthday

Baptism Date

Confirmation Date

I/we are requesting membership in St. James Episcopal Church: Yes No

Please request my/our transfer from the following church:

(Check all that apply) I/we wish to be contacted about

Baptism Confirmation Reception into the Episcopal Church.

May we contact you? Yes No

Do you have any questions?

St. James Episcopal Church

Ancient Worship. . .Open Minds. . .
Come Inside. . .Make a Difference

Katherine B. Moorehead, Rector