Request for Membership Tost. Andrew S Lutheran Church

REQUEST FOR MEMBERSHIP TOST. ANDREW’S LUTHERAN CHURCH

Mahtomedi, Minnesota

ADULT #1 Single Married Widowed Divorced

LAST NAME______FIRST NAME______

Middle Name/Initial______I Prefer to be Called______

BIRTHDATE______(Month/Day/Year)Birth City, State______

HOME ADDRESS______

(Street, City, State, Zip)

HOME PHONE______Work or Cell______

E-MAIL______

FORMER CONGREGATION______

Address______

City, State______

Baptized?Yes No Date______(Month/Day/Year)

Congregation Name, City, State______

Confirmed? Yes NoDate______(Month/Day/Year)

Congregation Name, City, State______

OCCUPATION (or Previous Occupation)______

Place of Employment______

Work Address______

EMERGENCY CONTACT______

(Please list a family member, their relationship to you, and contact information.)

PLEASE ANSWER FOLLOWING:

1)When did you start attending St. Andrew’s______

2)If you are currently involved in any ministries at St. Andrew’s, please list

______
______

3)List ministries that you would like to become involved______

______

OVER

ADULT #2 Single Married Widowed Divorced

LAST NAME______FIRST NAME______

Middle Name/Initial______I Prefer to be Called______

BIRTHDATE______(Month/Day/Year)Birth City, State______

HOME ADDRESS______

(Street, City, State, Zip)

HOME PHONE______Work or Cell______

E-MAIL______

FORMER CONGREGATION______

Address______

City, State______

Baptized?Yes No Date______(Month/Day/Year)

Congregation Name, City, State______

Confirmed? Yes NoDate______(Month/Day/Year)

Congregation Name, City, State______

OCCUPATION (or Previous Occupation)______

Place of Employment______

Work Address______

EMERGENCY CONTACT______

(Please list a family member, their relationship to you, and contact information.)

PLEASE ANSWER FOLLOWING:

1)When did you start attending St. Andrew’s______

2)If you are currently involved in any ministries at St. Andrew’s, please list

______
______

3)List ministries that you would like to become involved______

CHILDREN LIVING AT HOME

#1

CHILD IS A MEMBER OF ST. ANDREW’S ? Yes NoJOINING at this time? Yes No

LAST NAME______FIRST NAME______MIDDLE______

Prefer to be Called______

Male FemaleSchool Gr.______BIRTH DATE______City/State______

BAPTIZED? Yes No Date______(Month/Day/Year)

Congregation Name, City, State______

CONFIRMED? Yes No Date______(Month/Day/Year)

Congregation Name, City, State______

**************************************************************************************************

#2

CHILD IS A MEMBER OF ST. ANDREW’S ? Yes NoJOINING at this time? Yes No

LAST NAME______FIRST NAME______MIDDLE______

Prefer to be Called______

Male FemaleSchool Gr.______BIRTH DATE______City/State______

BAPTIZED? Yes No Date______(Month/Day/Year)

Congregation Name, City, State______

CONFIRMED? Yes No Date______(Month/Day/Year)

Congregation Name, City, State______

**************************************************************************************************

#3

CHILD IS A MEMBER OF ST. ANDREW’S ? Yes NoJOINING at this time? Yes No

LAST NAME______FIRST NAME______MIDDLE______

Prefer to be Called______

Male FemaleSchool Gr.______BIRTH DATE______City/State______

BAPTIZED? Yes No Date______(Month/Day/Year)

Congregation Name, City, State______

CONFIRMED? Yes No Date______(Month/Day/Year)

Congregation Name, City, State______

CHILDREN LIVING AT HOME

#4

CHILD IS A MEMBER OF ST. ANDREW’S ? Yes NoJOINING at this time? Yes No

LAST NAME______FIRST NAME______MIDDLE______

Prefer to be Called______

Male FemaleSchool Gr.______BIRTH DATE______City/State______

BAPTIZED? Yes No Date______(Month/Day/Year)

Congregation Name, City, State______

CONFIRMED? Yes No Date______(Month/Day/Year)

Congregation Name, City, State______

**************************************************************************************************

#5

CHILD IS A MEMBER OF ST. ANDREW’S ? Yes NoJOINING at this time? Yes No

LAST NAME______FIRST NAME______MIDDLE______

Prefer to be Called______

Male FemaleSchool Gr.______BIRTH DATE______City/State______

BAPTIZED? Yes No Date______(Month/Day/Year)

Congregation Name, City, State______

CONFIRMED? Yes No Date______(Month/Day/Year)

Congregation Name, City, State______

**************************************************************************************************

#6

CHILD IS A MEMBER OF ST. ANDREW’S ? Yes NoJOINING at this time? Yes No

LAST NAME______FIRST NAME______MIDDLE______

Prefer to be Called______

Male FemaleSchool Gr.______BIRTH DATE______City/State______

BAPTIZED? Yes No Date______(Month/Day/Year)

Congregation Name, City, State______

CONFIRMED? Yes No Date______(Month/Day/Year)

Congregation Name, City, State______

Return completed application to St. Andrew’s Lutheran Church, ATT: Ronda Sowada, 900 Stillwater Rd., Mahtomedi, MN 55115

or scan and email to