Membership Information
.
 
Name:  * 
Address:
 
City:
State/Province:  Zip: 
Phone number(s):
Email:  * 


Other family members:   
 

Emergency contact /
Next of kin:
(and contact info)
Birthday(s):
(year will not be
publicized)

 

Baptized?
If so, when?
(at least the year)
Where?
(church, city, state,
country - if known)

 

 

Confirmed?
If so, when/where?
 

 
Transferred
membership to
St. Mary Magdalene?:
 
If not, do you want 
to transfer?
(If so, name and
location of previous
church)
 


 
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