e Church of

St. Joseph of Arimathea

103 Country Club Dr.
Hendersonville, TN 37075

Congregation information form

(Please return completed form to the church office)

How would you like mail addressed to your household?

_______________________________________________________________________________
Title & Name(s) [Example: Mr. & Mrs. John Doe, John Doe & Jane Smith etc...]

_______________________________________________________________________________
Street Address Apt. # City State Zip

______________________________ ______________________________
Home Phone (including area code) Primary email address

I/We would like to meet with the priest.

I/We would like to fill out a pledge card.
I/We would like Offering Envelopes.

Adults in your household

_____________________________________________ _____________________________________________
First Name Middle Name Last Name First Name Middle Name Last Name

_________________ __________________________ _________________ __________________________

Work Phone Other e-mail Work Phone Other e-mail

_________________ __________________________ _________________ __________________________

Date of Birth Wedding Date/Anniversary Date of Birth Wedding Date/Anniversary

Have you been Have you been

Baptized? Date: _____________________ Baptized? Date: _____________________

Denomination: _________________________ Denomination: _________________________

Confirmed? Date: _____________________ Confirmed? Date: _____________________

Denomination: ________________________ Denomination: ________________________

Received into the Episcopal Church? Date: _______ Received into the Episcopal Church? Date: _______

Request my Letter of Transfer from another Episcopal Church: Request my Letter of Transfer from another Episcopal Church:

____________________________________________ ____________________________________________
Name of Church City State Name of Church City State

Occupation: _________________________________ Occupation: _________________________________

I would like to explore getting baptized or I would like to explore getting baptized or
confirmed confirmed
I want to learn more about the Episcopal Church I want to learn more about the Episcopal Church
and St. Joseph of Arimathea and St. Joseph of Arimathea
Others in your household

______________________________________________ ______________________________________________
First Name Middle Name Last Name First Name Middle Name Last Name

Personal e-mail:_________________________________ Personal e-mail:_________________________________

Date of birth: ____________ Grade in School: ______ Date of birth: ____________ Grade in School: ______

Have you been Have you been

Baptized? Date: _____________________ Baptized? Date: _____________________
Denomination: __________________________ Denomination: __________________________
Confirmed? Date: ______________________ Confirmed? Date: ______________________
Denomination: _________________________ Denomination: _________________________
Received into the Episcopal Church? Date: _______ Received into the Episcopal Church? Date: _______

Request my Letter of Transfer from another Episcopal Church: Request my Letter of Transfer from another Episcopal Church:

______________________________________________ ______________________________________________
Name of Church City State Name of Church City State

______________________________________________ ______________________________________________
First Name Middle Name Last Name First Name Middle Name Last Name

Personal e-mail:_________________________________ Personal e-mail:_________________________________

Date of birth: ____________ Grade in School: ______ Date of birth: ____________ Grade in School: ______

Have you been Have you been

Baptized? Date: _____________________ Baptized? Date: _____________________
Denomination: __________________________ Denomination: __________________________
Confirmed? Date: ______________________ Confirmed? Date: ______________________
Denomination: _________________________ Denomination: _________________________
Received into the Episcopal Church? Date: _______ Received into the Episcopal Church? Date: _______

Request my Letter of Transfer from another Episcopal Church: Request my Letter of Transfer from another Episcopal Church:

______________________________________________ ______________________________________________
Name of Church City State Name of Church City State

______________________________________________ ______________________________________________
First Name Middle Name Last Name First Name Middle Name Last Name

Personal e-mail:_________________________________ Personal e-mail:_________________________________

Date of birth: ____________ Grade in School: ______ Date of birth: ____________ Grade in School: ______

Have you been Have you been

Baptized? Date: _____________________ Baptized? Date: _____________________
Denomination: __________________________ Denomination: __________________________
Confirmed? Date: ______________________ Confirmed? Date: ______________________
Denomination: _________________________ Denomination: _________________________
Received into the Episcopal Church? Date: _______ Received into the Episcopal Church? Date: _______

Request my Letter of Transfer from another Episcopal Church: Request my Letter of Transfer from another Episcopal Church:

______________________________________________ ______________________________________________
Name of Church City State Name of Church City State