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Family Name
Family Already Registered With LPC?
Yes
No
Address
Apartment, suite, etc.
City
State
Zip/Postal Code
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Member Name
First Name
Last Name
Preferred Name
Title
Mr.
Mrs.
Ms.
Dr.
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Date Baptized
Month
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February
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June
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October
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Date
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1979
Year
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1981
1982
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1995
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Best Way To Contact You
Phone
Text
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Any
Occupation
Interest/Hobbies
Child's Name
Age
Nursery Needed
Yes
No
Grade in School
School Name
Baptized
Yes
No
I/We Would Like Information On Baptism
Choice One
Child's Name
Age
Nursery Needed
Yes
No
Grade in School
School Name
Baptized
Yes
No
I/We Would Like Information On Baptism
Choice One
Child's Name
Age
Nursery Needed
Yes
No
Grade in School
School Name
Baptized
Yes
No
I/We Would Like Information On Baptism
Choice One
I/We Would Like To Know More About:
Sunday School
Choir
Care Team
Women's Circle
Liturgist
Sunshiners
Lunch Bunch
Handbell Choir
For Office Use Only
Met With Session
Entered Into Subsplash
Entered Into Directory
Welcome Letter Sent
Date Set To Join
Month
January
February
March
April
May
June
July
August
September
October
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December
Date
1
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1951
1952
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1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
Year
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
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