St. Francis Episcopal Church
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Become a Member

In order that we may update our parish records, please fill out the following form as completely as possible. Your cooperation is appreciated.

Full Name 1:

 Preferred Name:
Birth Date:
  
Baptized: Yes No

Date:
Confirmed: Yes No

Date:
Full Name 2:
 Preferred Name:
Birth Date:
  
Baptized: Yes No

Date: 		Confirmed: Yes No

Date:
Home Address:
City:
 State:
 Zip:
Home Telephone #:
  
Marital Status:
 Marriage Anniversary Date:
Employment / Occupation:  
Member 1:
 Office Telephone #:
Member 2:
 Office Telephone #:
Children:
#1
#2
#3
#4
Name:
Birth Date:
Baptized:
Confirmed:
Transfer Information: Do you wish to transfer to St. Francis? Yes No
If yes, please enter the name and address of the church you're transferring from below:
Church Name:
Address:
City:
 State:
 Zip:

Access Code (enter all CAPS below):

Please enter the access code from above (this helps us prevent spam):

 
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©2007 Copyright - All Rights Reserved - St. Francis Episcopal Church
3506 Lawndale Drive • Greensboro, NC 27408 • Phone: (336) 288-4721