United Church of Christ in the Philippines
MIS Form No. MPDS 01
Attached
1x1
Picture
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Local Church Membership
MEMBERSHIP PERSONAL DATA SHEET
Name:
Home Address:
Birth date:
Birthplace:
Civil Status:
( ) s ( ) m ( ) others:
Parents: Mother
Baptism: Place / Church:
Date of Baptism:
If married, name of spouse:
Wedding Date:
Name
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Nickname:
Tel. No:
Sex: ( ) M ( )
F
Citizenship:
Father:
Officiating Minister:
Citizenship:
No. Of children:
Birth date
Occupation:
Place:
Office Address:
Education: School /Degree / Year Graduated:
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Professional License: ____________________________________
Involvement in Church Organizations or Ministries
Organization / Committee / Program
Position / responsibility
Inclusive Dates
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Other Related Involvements (Optional)
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Interest / Skills
( ) Singing
( ) Playing Musical Instruments (specify) ________________________
( ) Preaching
( ) Organizing / Facilitating group activities ( ) Teaching Children / Adults
(Please encircle)
( ) Others (please specify)
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Right
Thumb
mark
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Date
Signature
Blood
type
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------Accepted as (type of membership)______________________ members on
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through_________________________________________________________________________________________________
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Board of Elder
