First Name (Please add maiden name if applicable)

Last Name

Cell Phone Number

Home Phone Number

Birthdate

Birthplace (City, County, State)

Father's Name (Last, First)

Mother's Name (Last, First, Maiden Name)

Were you baptized?
Yes
No

Please list Baptism date and Pastor

Congregation, including Denomination, Synod, and location of Baptism:

Please list Confirmation date and Pastor, as well as Congregation (Denomination and Synod) and location:

If you were not Confirmed, did you go through Adult Instruction?
Yes
No

Most recent Church Membership (Congregation, Denomination, Synod, City State)

Do you have a letter of transfer? (If so, please send to Trinity Church office)
Yes
No

Occupation and Employer:

Marital Status:
Single
Married
Divorced
Widowed

Wedding Date:

Spouse's Name (Last, First)

Spouse's Date of Death (if widowed)

Spouse's Congregation:

Please list ALL your children, along with their date-of-birth and if they will be a member of Trinity: