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Information Form

Information Form

Full Name (required): Your Email (required):

Address City , State Zip

Phones: Home Cell Work

Birth date: Marital Status Wedding Anniversary

Baptized? Date: Where?

Confirmed? Date: Where?

How did you find out about Epiphany?

Members of Epiphany are expected to regularly attend worship services, give financially to support the ministry of the church, and be involved in ministry at Epiphany. Would you like to become a member? Previous Church Attended?

Can we publish your name, address, phone number and email in our Parish Directory?

Spouse (if applicable)

Full Name: Email:

Phones: Cell Work

Birth date:

Baptized? Date: Where?

Confirmed? Date: Where?

Children Under Age of 18

Child 1:

Full Name: Birth date: Current Grade:

Baptized? Date: Where?

Confirmed? Date: Where?

Child 2:

Full Name: Birth date: Current Grade:

Baptized? Date: Where?

Confirmed? Date: Where?

Child 3:

Full Name: Birth date: Current Grade:

Baptized? Date: Where?

Confirmed? Date: Where?

Child 4:

Full Name: Birth date: Current Grade:

Baptized? Date: Where?

Confirmed? Date: Where?