FIRST UNITED
Congregational Information Sheet
The
following information will be kept on file for our permanent record of your
membership. Information will be kept confidential and used only for church
purposes. It will not be provided to any third parties outside the church
without your approval. It will also help the Church provide various membership
statistics to the Greater
PERSONAL
Last Name _______________ First Name ________________ Middle Initial
____ Preferred ________________
Home phone ________________________
(Check here if unlisted r) / Cell phone ______________________
Work phone (if you can take
personal calls) ________________________________________________________
Email address
________________________________________________________________________________
Employer
___________________________________________________________________________________
Position
____________________________________________________________________________________
FAMILY
Gender: Male r Female r Birthdate
(mm/dd/yyyy) _______ Birthplace
(city/state) __________________
Parents’ Names (please include mother’s maiden name):
___________________________________________
Racial/Ethnic Group (please check one): Asian
r African-American/Black r Hispanic r Multi-racial r
Native American r Pacific Islander r White r
Marital Status: Single
r Married r Divorced r Widowed r
If married, spouse’s name: _____________________________ Anniversary
date: ______________________
Children’s names (first/last) and birthdates*:
1.
__________________________________________________________________________________________
2.
__________________________________________________________________________________________
3.
__________________________________________________________________________________________
4.
__________________________________________________________________________________________
(Note: Use back of sheet if
necessary. If child has been baptized, he/she should also be listed on a
separate form so that we have a form for each individual church member.)
If you are related to other FUMC members (parents,
siblings, etc.), please list names and how related
(use back of form if needed):
Name Relationship
________________________________________ _______________________________________
________________________________________ _______________________________________
CHURCH LIFE
Date Baptized ____________ Baptism Location (church/city/state)
_______________________________
Date joined Glassboro FUMC _________ By: Baptism r Profession
of Faith r
Transfer from other
EMERGENCY CONTACT
Name ____________________________
Relationship _________________ Phone _____________________
Thank
you for taking the time to complete this form. It will be help our office
manager and
Membership
Secretary keep accurate membership records now and into the future.
____________________________________________________________________________________________
FOR OFFICE USE ONLY
Member Type: Baptized Member
r Professing
Member r Constituent Member r