New Member Form

PERSONAL INFORMATION

Please note that more spouse and children information will go on separate form – just click "Add Additional Family Member" below. One form will need to be filled out for each family member.

First Name *

Middle Name

Last Name *

Preferred Name (or Nickname)

Date of Birth *

Place of Birth (city/state/country) *

Email Address *

Gender *

Home Address (incl. city/state/zip) *

Mailing Address (if different from home address, incl. city/state/zip)

Home Phone Number *

Mobile Phone Number *

Marital Status *

Full Name of Spouse (if married)

Anniversary Date (if applicable)

Marriage Church (church name / location)

Number of Children (if applicable)

Full Names of All Children

Disabilities / Special Needs (if any, optional)

Health Problems (if any, optional)

Parents' Names (for historical record) *

Ethnic Background (optional, for ELCA statistical purposes)

CHURCH INFORMATION

Service Preference (early or late)

How are you coming to St. Andrew? (please check one) *

Baptism

Affirmation of Baptism

Transfer

If you are transferring to St. Andrew, please tell us the Church from which you will be transferring:

Former Church Name

Former Church - Full Address (incl. city/state/zip)

Baptism Date *

Baptism Church (incl. city/state) *

First Communion Date (incl. church & location) *

Confirmation Date (incl. church & location) *

Activities You Would Consider Participating in at St. Andrew

EMPLOYMENT, EDUCATION & INTERESTS

Vocation (please include even if retired or not currently practicing)

Employer(s)

Church Offices Previously Held

Active or Retired Military, Civil Service or other Professional Title

Current School & Grade (if in school) or College & Year (if currently attending)

College Degree Attained & Major

Hobbies & Interests

INTRODUCTION

Comments About Yourself That We Could Include in a Brief Introduction in the Newsletter *