MEMBER INFORMATION
MEMBER INFORMATION Baptism is required for membership. If you would like to schedule a baptism, please call the church office, 701.282.3309.
Household Name(s): Household Address: Household Phone: Household Email Address:___________________________________________________________________ Do we have permission to print information supplied above in the list of new members in the church bulletin and newsletter? Y / N Do we have permission to post your photo on our New Member bulletin board? Y / N Do you prefer to receive the newsletter by ____mail ____email Would you like to receive the weekly E-News? Y / N Do you prefer to be contacted by ____phone ____text ____email (number in order of preference)
Please complete info for each new member Full Name: ___________________________________________ Preferred Name (If different):_______________________ Cell Phone:_________________________________ Home Email:________________________________ Male Female Birth Date: _____________ Baptized? Y / N *Date_____________________ Confirmed? Y / N *Date____________________ Previous Church:_____________________________ City & State:________________________________ ELCA?: Y / N
Full Name of Spouse/Significant Other: __________________________________________ Preferred Name (If different):______________________ Continue if spouse/significant other will be joining: Cell Phone:________________________________ Home Email:________________________________ Male Female Birth Date: ____________ Baptized? Y / N *Date______________________ Confirmed? Y / N *Date___________________ Previous Church:____________________________ City & State:________________________________ ELCA?: Y / N
If obtainable, we will submit a ‘Request for Transfer of Membership’ from your previous church. Please indicate all names that should be included on the transfer: _______________________________________________ _______________________________________________ _______________________________________________
Indicate all names to be listed on ‘Request for Transfer’ from previous church (if different than spouse/significant other):_________________________________________ ______________________________________________ ______________________________________________ ______________________________________________
I am: (circle one) Single, Engaged, Married, Separated, Divorced, Widowed Wedding Date:____________
I am: (circle one) Single, Engaged, Married, Separated, Divorced, Widowed Maiden Name (if applicable):___________________
Employer: __________________________________ Occupation:_________________________________ *Work Phone: ____________________ *Work Email:_______________________________
Employer: _________________________________ Occupation:________________________________ *Work Phone: ______________________________ *Work Email:_______________________________
*Ethnic Origin (optional) __White, __African Amer/Black, __Asian/Pacific Islander, __Amer.Ind/Alaska Native, __ Latino/Hispanic, Arab/Middle Eastern, __Multiracial, __Other
*Ethnic Origin (optional) __White, __African Amer/Black __Asian/Pacific Islander, __Amer.Ind/Alaska Native, __ Latino/Hispanic, Arab/Middle Eastern, __Multiracial, __Other
*Optional
Enter children’s information on reverse side
Child: Full Name:______________________________________ Preferred Name:__________________________________ Male Female Birth Date: _________________ Father’s Name:__________________________________ Mother’s Name:__________________________________ Baptized? Y / N *Date______________________ Confirmed? Y / N *Date______________________
Child: Full Name:_______________________________________ Preferred Name:___________________________________ Male Female Birth Date: __________________ Father’s Name:___________________________________ Mother’s Name:___________________________________ Baptized? Y / N *Date_______________________ Confirmed? Y / N *Date_______________________
Previous Church:_____________________________ City & State:________________________________ ELCA? Y / N
Previous Church:______________________________ City & State:_________________________________ ELCA? Y / N
School Grade:________ *Ethnic Origin (optional) __White, __African Amer/Black, __Asian/Pacific Islander, __Amer.Ind/Alaska Native, __ Latino/Hispanic, Arab/Middle Eastern, __Multiracial, __Other
School Grade:________ *Ethnic Origin (optional) __White, __African Amer/Black, __Asian/Pacific Islander, __Amer.Ind/Alaska Native, __ Latino/Hispanic, Arab/Middle Eastern, __Multiracial, __Other
Child: Full Name:______________________________________ Preferred Name: _________________________________ Male Female Birth Date: _________________ Father’s Name: __________________________________ Mother’s Name: _________________________________ Baptized? Y / N *Date______________________ Confirmed? Y / N *Date______________________
Child: Full Name: ______________________________________ Preferred Name: __________________________________ Male Female Birth Date: __________________ Father’s Name: ___________________________________ Mother’s Name: __________________________________ Baptized? Y / N *Date_______________________ Confirmed? Y / N *Date_______________________
Previous Church:_____________________________ City & State:________________________________ ELCA? Y / N
Previous Church:______________________________ City & State:________________________________ ELCA? Y / N
School Grade:________ *Ethnic Origin (optional) __White, __African Amer/Black, __Asian/Pacific Islander, __Amer.Ind/Alaska Native, __ Latino/Hispanic, Arab/Middle Eastern, __Multiracial, __Other
School Grade:________ *Ethnic Origin (optional) __White, __African Amer/Black, __Asian/Pacific Islander, __Amer.Ind/Alaska Native, __ Latino/Hispanic, Arab/Middle Eastern, __Multiracial, __Other
Household Name(s): Household Address: Household Phone: Household Email Address:___________________________________________________________________ Do we have permission to print information supplied above in the list of new members in the church bulletin and newsletter? Y / N Do we have permission to post your photo on our New Member bulletin board? Y / N Do you prefer to receive the newsletter by ____mail ____email Would you like to receive the weekly E-News? Y / N Do you prefer to be contacted by ____phone ____text ____email (number in order of preference)
Please complete info for each new member Full Name: ___________________________________________ Preferred Name (If different):_______________________ Cell Phone:_________________________________ Home Email:________________________________ Male Female Birth Date: _____________ Baptized? Y / N *Date_____________________ Confirmed? Y / N *Date____________________ Previous Church:_____________________________ City & State:________________________________ ELCA?: Y / N
Full Name of Spouse/Significant Other: __________________________________________ Preferred Name (If different):______________________ Continue if spouse/significant other will be joining: Cell Phone:________________________________ Home Email:________________________________ Male Female Birth Date: ____________ Baptized? Y / N *Date______________________ Confirmed? Y / N *Date___________________ Previous Church:____________________________ City & State:________________________________ ELCA?: Y / N
If obtainable, we will submit a ‘Request for Transfer of Membership’ from your previous church. Please indicate all names that should be included on the transfer: _______________________________________________ _______________________________________________ _______________________________________________
Indicate all names to be listed on ‘Request for Transfer’ from previous church (if different than spouse/significant other):_________________________________________ ______________________________________________ ______________________________________________ ______________________________________________
I am: (circle one) Single, Engaged, Married, Separated, Divorced, Widowed Wedding Date:____________
I am: (circle one) Single, Engaged, Married, Separated, Divorced, Widowed Maiden Name (if applicable):___________________
Employer: __________________________________ Occupation:_________________________________ *Work Phone: ____________________ *Work Email:_______________________________
Employer: _________________________________ Occupation:________________________________ *Work Phone: ______________________________ *Work Email:_______________________________
*Ethnic Origin (optional) __White, __African Amer/Black, __Asian/Pacific Islander, __Amer.Ind/Alaska Native, __ Latino/Hispanic, Arab/Middle Eastern, __Multiracial, __Other
*Ethnic Origin (optional) __White, __African Amer/Black __Asian/Pacific Islander, __Amer.Ind/Alaska Native, __ Latino/Hispanic, Arab/Middle Eastern, __Multiracial, __Other
*Optional
Enter children’s information on reverse side
Child: Full Name:______________________________________ Preferred Name:__________________________________ Male Female Birth Date: _________________ Father’s Name:__________________________________ Mother’s Name:__________________________________ Baptized? Y / N *Date______________________ Confirmed? Y / N *Date______________________
Child: Full Name:_______________________________________ Preferred Name:___________________________________ Male Female Birth Date: __________________ Father’s Name:___________________________________ Mother’s Name:___________________________________ Baptized? Y / N *Date_______________________ Confirmed? Y / N *Date_______________________
Previous Church:_____________________________ City & State:________________________________ ELCA? Y / N
Previous Church:______________________________ City & State:_________________________________ ELCA? Y / N
School Grade:________ *Ethnic Origin (optional) __White, __African Amer/Black, __Asian/Pacific Islander, __Amer.Ind/Alaska Native, __ Latino/Hispanic, Arab/Middle Eastern, __Multiracial, __Other
School Grade:________ *Ethnic Origin (optional) __White, __African Amer/Black, __Asian/Pacific Islander, __Amer.Ind/Alaska Native, __ Latino/Hispanic, Arab/Middle Eastern, __Multiracial, __Other
Child: Full Name:______________________________________ Preferred Name: _________________________________ Male Female Birth Date: _________________ Father’s Name: __________________________________ Mother’s Name: _________________________________ Baptized? Y / N *Date______________________ Confirmed? Y / N *Date______________________
Child: Full Name: ______________________________________ Preferred Name: __________________________________ Male Female Birth Date: __________________ Father’s Name: ___________________________________ Mother’s Name: __________________________________ Baptized? Y / N *Date_______________________ Confirmed? Y / N *Date_______________________
Previous Church:_____________________________ City & State:________________________________ ELCA? Y / N
Previous Church:______________________________ City & State:________________________________ ELCA? Y / N
School Grade:________ *Ethnic Origin (optional) __White, __African Amer/Black, __Asian/Pacific Islander, __Amer.Ind/Alaska Native, __ Latino/Hispanic, Arab/Middle Eastern, __Multiracial, __Other
School Grade:________ *Ethnic Origin (optional) __White, __African Amer/Black, __Asian/Pacific Islander, __Amer.Ind/Alaska Native, __ Latino/Hispanic, Arab/Middle Eastern, __Multiracial, __Other
