Become a St. John’s UMC Member

Want to become a member of St. John’s? Use the membership form below to submit your information.

Date*
MM slash DD slash YYYY
Service*
- 8:00 AM
- 10:00 AM
Name*
First Last
Age*
Date Of Birth (DOB)*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Cell Phone*
Work Phone
Email
Occupation/Job Description/Type of Work*
Race/Ethnicity*
- Black
- White
- Hispanic
- Asian
Highest Level of Education Achieved*
- High School
- Associate Degree
- Bachelor's Degree
- Graduate of Professional Degree
- Some College
- Prefer Not to Answer
FAMILY INFORMATION:
Marital Status*
- Single
- Married
- Divorced
- Widowed
Spouse’s Name*
First Last
Male/Female*
- Male
- Female
Spouse’s Age*
Spouse’s DOB*
MM slash DD slash YYYY
Spouse’s E-Mail Address:
Spouse's Phone
Is Spouse a Member/Joining Church?*
- Yes
- No
Do You Have Children?*
- Yes
- No
How Many Children?*
Name*
First Last
Age*
Child DOB*
MM slash DD slash YYYY
Male/Female*
- Male
- Female
Chlid 2 Name*
First Last
Child 2 Age*
Child 2 DOB*
MM slash DD slash YYYY
Child 2 Male/Female*
- Male
- Female
Chlid 3 Name*
First Last
Child 3 Age*
Child 3 DOB*
MM slash DD slash YYYY
Child 3 Male/Female*
- Male
- Female
4 or More Children?
Enter Children Name, Member Status, Male/Female and Date of Birth in the box above.
Are Children Members/Joining Church?*
- Yes
- No
In case of an emergency, contact
Name*
Phone*
Relationship to You*
I AM COMING TO ST. JOHN’S
First time to Christ*
- Yes
- No
Denomination
Transferred From
Not a member of another church.

FAMILY INFORMATION: