Your Name:
Today’s Date:
Mailing Address:
Phone:
E-Mail :
Household Member s’ Name
Relationship
Date of Birth
Self
Self
Spouse Child Parent GrandChild Other
Spouse Child Parent GrandChild Other
Spouse Child Parent GrandChild Other
Spouse Child Parent GrandChild Other
Spouse Child Parent GrandChild Other
Spouse Child Parent GrandChild Other
Additional Information
Wedding Anniversary (or other significant date)
Previous Church Community (if any):
Location:
Please have a clergy person or Vestry member contact me
Preferred Time to Call: Morning Afternoon Evening
Preferred Means of Contact: Phone Email Visit Letter
Request Additional Information (mark all that apply with an X)
Diocesan Monthly Newspaper
Ministries for Adults
Electronic News from the Larger Church
Ministries for Families (Children and Youth)
Education and Formation for Adults
Outreach to the Community
Education and Formation for Children &/or Youth
Worship Ministries (Readers, Eucharistic Min, Acolytes, Altar Guild, etc.)
Transferring my Membership to St Peter’s
Information about Stewardship Commitments
Special Occasion: Wedding Baptism Confirmation
Information about Planned Giving
Other:
Other:
St. Peter’s Episcopal Church does not supply the personal information of members to organizations outside the ministry, relationships, and regular communications of the Protestant Episcopal Church in the United States.
