Saint Thomas Parish
P.O. Box 1132, Morton Grove, IL 60053
Membership/Supporter Form
Name: _________________________________________________________________
Address: _______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Home Phone: _______________________ Cell Phone: ___________________
Email: ___________________________ Annual Membership: __________
Parishioners Donation: _________
Occupation: ______________________ Date of Birth: _________________
List of Family Members
1. ________________________ DOB: ______________________ Relationship: ________________
2. ________________________ DOB: ______________________ Relationship: ________________
3. ________________________ DOB: ______________________ Relationship: ________________
4. ________________________ DOB: ______________________ Relationship: ________________
5. ________________________ DOB: ______________________ Relationship: ________________
Statement of Membership for Members Only
I, __________________________________________, the undersigned below do hereby apply
To become a member in the Church of the East (in the State of Illinois). As a baptized Christian, I recognize my Christian duty and pledge to lead a Christian example of life, to be prepared spiritually to receive the Sacraments of the Church and to the best of my ability follow, respect and adhere Biblical teachings and Church Canons, in addition to the rules and decrees governing this jurisdiction of the Church of the East.
Signature: ________________________________________ Date: _____________
