Membership Application

Please fill out this form and click submit.

Personal Information

Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Date of Birth

*

Baptized?

*

Please select all that apply.

Yes No

Location

*

Date

*

Confirmed Episcopalian?

*

Please select all that apply.

Yes No

Location

*

Date

*

Occupation

*

Would you like to receive the weekly parish e-newsletter?

*

Please select all that apply.

Yes No

Partner and Family Information

If you do not have a spouse or partner, skip this section. If your spouse or partner does not wish to become a member of Saint Philip's, please simply provide us with their name and age.

Name

Email

Phone

Address

Date of Birth

Baptized?

Please select all that apply.

Yes No

Location

Date

Confirmed Episcopalian?

Please select all that apply.

Yes No

Location

Date

Occupation

Please provide the names and ages of any children who live with you, noting whether each child has been baptized and whether each child has been confirmed.

Current Church Affiliation

What is the name of the church where you currently attend, if any?

*

Description

Please fill out this form and click submit.

Please Fix the Following

Close