Forms

New Membership Information

We are so glad you have chosen to make Asbury your church home! Please take a few moments to fill out this information so we can have it for our records. This information will be kept in complete confidence.

First Name*
Middle Name*
Last Name*
Date Joined*
Title
Suffix
Address*
Street Address City State / Province / Region ZIP / Postal Code
Home Phone
(***)***-****
Cell Phone
(***)***-****
Work Phone
(***)***-****
Emergency Contact (Name & Relation):
Phone of Emergency Contact
Primary Email Address*
Alternate Email Address
Birthday*

mm/dd/yyyy
Baptism Date

mm/dd/yyyy
Place of employment
Occupation
If the new member is a child, list parents' names
Is there a former church?
Denomination?*
Can we contact your former church?*
We would contact your former church to request transfer of membership, and any other pertinent information for our membership rolls.
Name of former church*
Address of former church
Street Address City State / Province / Region ZIP / Postal Code
Was this the former church of all members of your household?*
List any other family members joining from this former church
Name Relation

Add more members by clicking the "+" icon to the right of the 'Relation' field.
Marital Status*
Anniversary Date

mm/dd/yyyy
Name of Spouse
First Name Middle Name Last Name
Title
Suffix
Cell Phone
(***)***-****
Work Phone
(***)***-****
Emergency Contact (Name & Relation):
Phone of Emergency Contact
Primary Email Address
Alternate Email Address
Birthday*

mm/dd/yyyy
Baptism Date

mm/dd/yyyy
Place of employment
Occupation
Children?*
Child 1
First Name Middle Name Last Name
Title
Suffix
Birthday

mm/dd/yyyy
Baptism Date

mm/dd/yyyy
Confirmed?
Child 2
First Name Middle Name Last Name
Title
Suffix
Birthday

mm/dd/yyyy
Baptism Date

mm/dd/yyyy
Confirmed?
Child 3
First Name Middle Name Last Name
Title
Suffix
Birthday

mm/dd/yyyy
Baptism Date

mm/dd/yyyy
Confirmed?
Child 4
First Name Middle Name Last Name
Title
Suffix
Birthday

mm/dd/yyyy
Baptism Date

mm/dd/yyyy
Confirmed?
Child 5
First Name Middle Name Last Name
Title
Suffix
Birthday

mm/dd/yyyy
Baptism Date

mm/dd/yyyy
Confirmed?
Child 6
First Name Middle Name Last Name
Title
Suffix
Birthday

mm/dd/yyyy
Baptism Date

mm/dd/yyyy
Confirmed?
Child 7
First Name Middle Name Last Name
Title
Suffix
Birthday

mm/dd/yyyy
Baptism Date

mm/dd/yyyy
Confirmed?
Comments
This field is for validation purposes and should be left unchanged.

Member Resources

Archives

Search our Website

Latest Blog Posts

Upcoming Events

ACCDC 2019/2020 Classes

Chancel Choir Rehearsal

LAUNCH Team Rehearsal

Forms

New Membership Information

New Membership Information