New Member Request | St John Lutheran Church

Head of Household

Name: (Required)

Birth Date: (Required)

Baptism Date:

Confirmation Date:

Confirmation Verse:

Home Phone:

Cell Phone: (Required)

Email:

Spouse (Only if Member)

Name:

Birth Date:

Baptism Date:

Confirmation Date:

Confirmation Verse:

Home Phone:

Cell Phone:

Email:

Home Address

Please verify that we have your correct home address in our records by supplying your home address below

Street:

Faith History (Head of Household)

Public profession of faith means you were confirmed or baptized

I was baptized as an infant, but never accepted Jesus as my personal Lord and Savior

I was baptized as an infant & have accepted Jesus as my Lord & Savior, but haven't made a public profession of faith

I was baptized as an infant, have accepted Jesus as my Lord & Savior, & have made a public profession of faith

I made the decision to be baptized when I was old enough to make a public profession of my faith in Jesus

I have never been baptized

Faith History (Spouse)

Public profession of faith means you were confirmed or baptized

I was baptized as an infant, but never accepted Jesus as my personal Lord and Savior

I was baptized as an infant & have accepted Jesus as my Lord & Savior, but haven't made a public profession of faith

I was baptized as an infant, have accepted Jesus as my Lord & Savior, & have made a public profession of faith

I made the decision to be baptized when I was old enough to make a public profession of my faith in Jesus

I have never been baptized

Church Membership History (Head of Household)

I was an official member of another church and am transferring my membership

Name of Church/Denomination that I'm transferring from:

Church Membership History (Spouse)

I was an official member of another church and am transferring my membership

Name of Church/Denomination that I'm transferring from:

Children (Only if Members)

Name (Include last name if different):

Name of child #1

Birth Date:

DOB of child #1

Baptism Date:

Baptism date of child #1

Confirmation Date:

Confirmation date of child #1

Name:

Name of child #2

Birth Date:

DOB of child #2

Baptism Date:

Baptism date of child #2

Confirmation Date:

Confirmation date of child #2

Name:

Name of child #3

Birth Date:

DOB of child #3

Baptism Date:

Baptism date of child #3

Confirmation Date:

Confirmation date of child #3

Name:

Name of child #4

Birth Date:

DOB of child #4

Baptism Date:

Baptism date of child #4

Confirmation Date:

Confirmation date of child #4

Name:

Name of child #5

Birth Date:

DOB of child #5

Baptism Date:

Baptism date of child #5

Confirmation Date:

Confirmation date of child #5