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Contact Info
Please fill out this form separately for every member of your household.
First Name
Last Name
Gender
Male
Female
I'd rather not say
Primary Phone Number (If a child, use parent's)
Primary Email (If a child, use parent's)
Address
Apartment, suite, etc.
City
State
Zip/Postal Code
Have you received Christian baptism in the name of the Father, Son, and Holy Spirit?
No
Yes
Not sure
Have you been confirmed?
No
Yes
Not sure
Were you confirmed in (or received into) the Anglican tradition?
No
Yes
Not sure
Do you feel called or have any desire to publicly reaffirm your faith in Jesus when the bishop next visits?
No
Yes
Maybe
Have you signed the Prince of Peace Membership Covenant?
No
Yes
Not sure
Anything else you would like us to know?
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