About You

Title *

My Name *

First

Last

Maiden Name (if applicable) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Other Phone Number *

Email *

Are you wanting to join as a member? *

Yes, I'd like to join Not at this time

Birthdate (MM/DD/YYYY) *

Place of Birth (City, State) *

Church Background (Denomination, Unchurched, etc.) *

Are you Baptized? *

Yes No Not Sure

Baptism Date (if known) *

Have you been Confirmed? *

Yes No Not Sure

Confirmation Date (if known) *

Household Name (if different from Last) *

Others on this list? *

My family members' information is below It is just me

Name 2 *

First

Last

Occupation *

Role/Relationship *

Birth Date (MM/DD/YYYY) *

Wedding Date (MM/DD/YYYY) *

Email *

Phone Number (Cell) *

Is this person joining as a member? *

Yes, they are joining Not at this time Already are a member (or Not Applicable)

Baptized? *

Yes No Not Sure

Baptism Date (if known) *

Confirmed? *

Confirmation Date (if known) *

Phone Number (Work) *

Name 3 *

First

Last

Birth Date (MM/DD/YYY) *

Role/Relationship *

Baptized? *

Yes No Not Sure

Baptism Date (if known) *

Confirmed? *

Confirmation Date (if known) *

Write a couple sentences about you (your hobbies, your family, etc.) *

Which service do you usually attend? *

Saturday, 5:00 p.m. Sunday, 9:00 a.m. Sunday, 11:15 a.m.

If you are joining, are you transferring membership? Provide: Church Name, City, State *

Add another member...

* Indicates required field

Name *

First

Last

Birthdate (MM/DD/YYYY) *

Role/Relationship *

Baptized? *

Yes No Not Sure

Baptism Date (if known) *

Confirmed? *

Yes No Not Sure

Confirmation Date (if known) *

Parent Name *

First

Last

Parent 2 Name *

First

Last

Submit

Add another member...

* Indicates required field

Name *

First

Last

Birthdate (MM/DD/YYYY) *

Role/Relationship *

Baptized? *

Yes No Not Sure

Baptism Date (if known) *

Confirmed? *

Yes No Not Sure

Confirmation Date (if known) *

Parent Name *

First

Last

Parent 2 Name *

First

Last

Submit

We're glad you want to know about us...

We want to know about you, too!

Information Form

Tell us about other people we should know...

Other people we should know...

Add another member...

Add another member...

First Lutheran Church

1000 3rd Ave. SE, Cedar Rapids, IA | 319.365.1494 | info@firstlutherancr.org | A congregation of the ELCA

We're glad you want to know about us... ​​We want to know about you, too!

Information Form

Tell us about other people we should know...

Other people we should know...

Add another member...

Add another member...

First Lutheran Church

1000 3rd Ave. SE, Cedar Rapids, IA | 319.365.1494 | info@firstlutherancr.org | A congregation of the ELCA

We're glad you want to know about us...

We want to know about you, too!