Central Presbyterian Church: Home: New Member Information

Welcome to Central Presbyterian Church! We want to be sure we have your correct information in our database. Once we do, we will send you instructions on how to log in to your record within our database via the CPC website.

* Required

Errors

First Name

Middle

Last Name

Name you go by (if applicable)

Address Line 1

Address Line 2

City

State

ZIP Code

Birth Date

Home Phone Number
( ) - ext.

Work Phone Number
( ) - ext.

Mobile Phone Number
( ) - ext.

Preferred Phone Number

Home

Work

Mobile

Preferred Email Address

Occupation

Marital Status

Married/Partnered

Single

Widowed

Divorced

Separated

Ethnic Origin

Asian

Black

Caucasian

Hispanic

Other

Spouse/Partner's Name

Member of Central?

Yes

No

Joining at the Same Time

Children Living at Home (include college students)

First Name

Middle

Last Name

Birth Date

Has this child been baptized?

Yes

No

Date of Baptism

First Name

Middle

Last Name

Birth Date

Has this child been baptized?

Yes

No

Date of Baptism

First Name

Middle

Last Name

Birth Date

Has this child been baptized?

Yes

No

Date of Baptism

How did you united with Central?

Profession of Faith

Reaffirmation of Faith

Affiliation

Certificate of Transfer

Clergy Affiliation

If by Certficate of Transfer, Name and Address of Church

Have you been ordained

Elder

Deacon

Elder and Deacon

Clergy

Are you interested in any particular area(s) of service? If so, which one(s)

Are you interested in any particular Sunday School classe(es)? If so, which one(s)

Names of relatives, friends, acquaintances at Central