MEMBERSHIP INFORMATION

Full Name___________________________________ Nickname____________________

Address ______________________ City, State____________________Zip__________

E-Mail Address (Preferred) ____________________ (Secondary)___________________

Phone Number_____________ Ok to list in directory? Yes___ No___

Date of Birth________________ Place of Birth_________________________________

Baptized? Yes___ No___ If yes, Date and Place of Baptism _____________________

Confirmed? Yes___ No___ If yes, Date and Place of Confirmation _________________

Marital Status:  (Circle one unless you prefer to leave this question unanswered)

    Single    Married    Divorced    Widowed

Spouse’s Name (if applicable):_______________________________________

Date and Place of Marriage:________________________________________

Children joining with you:

Full Name                        Grade In School   Birth date/Place of Birth        Baptism Date & Place

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(Confirmed children should complete a separate Membership Form)

Place of Employment________________________________Position________________

Occupation______________________________________________________________

Work Phone______________________ O.K. to call you at work? ____________

Interests_________________________________________________________________

To be received by: (circle one)

    Baptism    Affirmation of Faith    Transfer    Associate Membership    

Why are you choosing to join New Covenant Lutheran Church?

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Present Church Membership________________________________________________________________________
                                                  Name of Church                                                      City,State,Zip

Do we need to request a transfer? Yes____No___

How did you discover New Covenant? (circle one)

    Friend    Drove by Church    Preschool    Arts Academy    Yellow Pages

Optional: If no current membership, what is your religious background, if any? _____________________________

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Although we do not give out member information to outside sources, we would appreciate knowing your professional skills and other talents as a resource for our church needs.

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