Membership Form
Please fill out this form for yourself and any other family members who are joining Peace.
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Email *
Adult 1: Full Name *
Contact Phone Number *
Adult 1: Previous Name, if applicable
Adult 1: Address *
Adult 1: Date of Birth *
MM
/
DD
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YYYY
Adult 1: Gender *
Adult 1: Marital Status *
Adult 1: Birthplace (City/State) *
Adult 1: Occupation *
Adult 1: Employer
Adult 1: Emergency Contact Name *
Adult 1: Relationship to Emergency Contact
Adult 1: Emergency Contact Phone Number *
Adult 1: Have you been baptized? *
Adult 1: Baptism date and location, if known
Adult 1: Have you been confirmed? *
Adult 1: Confirmation date and location, if known
Adult 1: Are you transferring to Peace from another church? *
Adult 1: May we contact your previous church to request a records transfer?
Clear selection
Adult 1: If Yes, please provide former church's name, location, and contact info
Adult 1: I'd like to meet with a staff member
Clear selection
Please mark any of the following areas that interest you, or that you have experience in. You are not committing to serve in any area that you mark, but we may contact you with opportunities to do so.

Adult 1: Professional Services
Adult 1: Arts
Adult 1: Construction
Adult 1: Teaching
Adult 1: Office Skills
Adult 1: Music
Adult 1: Mechanical
Adult 2: Full Name
Adult 2: Previous name, if applicable
Adult 2: Address
Clear selection
Adult 2: Address (if address is different from Adult 1)
Adult 2: Email
Adult 2: Date of Birth
MM
/
DD
/
YYYY
Adult 2: Gender
Clear selection
Adult 2: Marital Status
Clear selection
Adult 2: Birthplace (City/State)
Adult 2: Occupation
Adult 2: Employer
Adult 2: Emergency Contact Name
Adult 2: Emergency Contact Relationship
Adult 2: Emergency Contact Phone Number
Adult 2: Have you been baptized?
Clear selection
Adult 2: Baptism date and location, if known
Adult 2: Have you been confirmed?
Clear selection
Adult 2: Confirmation date and location, if known
Adult 2: Are you transferring to Peace from another church?
Clear selection
Adult 2: May we contact your previous church to request a records transfer?
Clear selection
Adult 2: If Yes, please provide former church's name, location, and contact info
Adult 2: I'd like to meet with a staff member
Clear selection
Please mark any of the following areas that interest you, or that you have experience in. You are not committing to serve in any area that you mark, but we may contact you with opportunities to do so.

Adult 2: Professional Services
Adult 2: Arts
Adult 2: Construction
Adult 2: Teaching
Adult 2: Office Skills
Adult 2: Music
Adult 2: Mechanical
Child 1: Full Name
Child 1: Date of Birth
MM
/
DD
/
YYYY
Child 1: Baptized
Clear selection
Child 1: Baptism date and location
Child 1: Gender
Clear selection
Child 2: Full Name
Child 2: Date of Birth
MM
/
DD
/
YYYY
Child 2: Baptized
Clear selection
Child 2: Baptism date and location
Child 2: Gender
Clear selection
Child 3: Full Name
Child 3: Date of Birth
MM
/
DD
/
YYYY
Child 3: Baptized
Clear selection
Child 3: Baptism date and location
Child 3: Gender
Clear selection
Child 4: Full Name
Child 4: Date of Birth
MM
/
DD
/
YYYY
Child 4: Baptized
Clear selection
Child 4: Baptism date and location
Child 4: Gender
Clear selection
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