Membership Form

Please fill out and submit the following form. In an effort to get to know you better, please upload a photo of you or your family. These photos are used for internal purposes only. If you have any questions or concerns, please contact Canon Lauren Holder.

(* Denotes Required Fields)

Required Personal Information
Would you like your membership announced in the Cathedral Times?: *	Yes No
Can you tell us how you heard about the Cathedral?:
Can you tell us why you decided to join the Cathedral?:
Full Name (First, Middle, Last): *
Preferred Name:
Date of Birth (mm/dd/yyyy) : *
Place of Birth (City, State): *
Street Address: *
City, State, Zip Code: *
Main Phone: *
Is this a cell phone?: *	Yes No
Alternate Phone:
Email Address: *
Marital Status: *	Single Married Partnered Divorced Widowed
Pledge Preference: *	Pledge Separately Pledge with Spouse/Partner
Occupation/Name of Workplace:
Work Phone:
Baptism/Confirmation/Transfer Information
Date of Baptism:
Denomination of Baptism: *
Place of Baptism (Church, City, State): *
Seeking Baptism?:	Yes No
Date of Confirmation (Only if confirmed in an Episcopal Church):
Place of Confirmation (Church, City, State): *
Seeking Confirmation?:	Yes No
Name of Last Church You Joined: *
Denomination of Last Church You Joined: *
Street Address:
City, State, Zip:
Phone Number:
Is spouse/partner joining the Cathedral?: *	Yes No
Spouse/Partner Information
If spouse/partner is joining the Cathedral, please complete this section; if not, please provide only your spouse's/partner's name, date of birth and phone number:
Full Name (First, Middle, Last):
Preferred Name:
Date (mm/dd/yyyy) and Place of Birth:
Occupation/Name of Workplace:
Work Phone:
Email Address:
Cell Phone:
Baptism/Confirmation/Transfer Information (Spouse)
If spouse/partner is joining the Cathedral, please complete this section; if not, move on to next section.:
Date of Baptism:
Denomination and Place of Baptism:
Seeking Baptism?:	Yes No
Date and Place of Confirmation (Only if confirmed in an Episcopal Church):
Seeking Confirmation?:	Yes No
Last Church You Joined (Include Name and Denomination):
Street Address:
City, State, Zip:
Phone Number:
Additional Family Members Living in the Same Household
1. Full Name (First, Middle, Last):
Relationship:
Preferred Name:
Date (mm/dd/yyyy) and Place of Birth:
Date of Baptism:
Denomination and Place of Baptism:
Date and Place of Confirmation (Only if confirmed in an Episcopal Church):
---------------:
2. Full Name (First, Middle, Last):
Relationship:
Preferred Name:
Date (mm/dd/yyyy) and Place of Birth:
Date of Baptism:
Denomination and Place of Baptism:
Date and Place of Confirmation (Only if confirmed in an Episcopal Church):
---------------:
3. Full Name (First, Middle, Last):
Relationship:
Preferred Name:
Date (mm/dd/yyyy) and Place of Birth:
Date of Baptism:
Denomination and Place of Baptism:
Date and Place of Confirmation (Only if confirmed in an Episcopal Church):
If children or other family members are joining the Cathedral, please complete this section; if not, you may skip it.:
Photo
Please upload a photo so we can get to know you: