Membership at Saint James

Today's date*

Please make your selection below. I want to:*

Be received

Be confirmed

Reaffirm my faith in the Episcopal Church

First name*

Middle Name*

Last name*

Address

Street Address City State Zip Code

Phone #1*

Type of number*

Mobile

Home

E-mail:*

Date of birth*

Place of birth*

Age (needed for Diocesan records)*

Parent or Guardian 1 (For youth 17 and under)

Parent or Guardian 2 (For youth 17 and under)(1)

Have you been baptized?*

Yes

No

Not sure

Date of baptism (N/A if unknown)*

Name of church where you were baptized (N/A if unknown)*

Location of baptism (N/A if unknown)*

Parent's full name*

Date of confirmation (N/A if unknown)*

Name of church where you were confirmed (N/A if unknown)*

Location of church where you were confirmed (N/A if unknown)*

Is there any other information you'd like to add?