Adult 1 in Household

Title:       First Name:       Last Name:  

Address:  

City:       Prov:       Postal Code:  

Home Phone:       Work Phone:       Fax:  

Email:       

Occupation:  

Emergency Contact Name/Phone#:  

Baptized?   Yes No

Adult 2 in Household

Title:       First Name:       Last Name:  

Home Phone:       Work Phone:       Fax:  

Email:

Occupation:

Emergency Contact Name/Phone#:  

Baptized?   Yes No

Children

Child's full name:    Birthdate:    Baptized?  Yes No

Child's full name:    Birthdate:    Baptized?  Yes No

Child's full name:    Birthdate:    Baptized?  Yes No

Service most frequently attended: 8 AM 9:30 AM 11:15 AM 7 PM Midweek

Parish Directory

We have a Parish Directory which is available to all members of our community.  Is there any information that you do NOT want shared?

Address    Home Phone    Work Phone    Cell Phone    Fax #   

Email Address     Children's Names     Other  

Gifts of Time, Talent and Treasure

Would you like to support the parish financially?

Yes - pre-authorized givings Yes - weekly envelopes Yes - monthly envelopes No

Person to whom the tax receipt should be issued: 

I would like to know more about:

Church School and/or Nursery                        The Anglican Church

Junior & Senior Youth Groups                        Baptism

Adult Christian Education Programs               Outreach

Our Music Program

I would like to speak to one of the clergy

Photographs are taken at many of our parish events.  If you do not wish your picture to appear in any of our church publications or on our website, please let us know checking the box below.  Your request will be treated in confidence and every reasonable effort will be made to ensure that your request is honoured.

Please do not use my image in parish publications

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