Mar Zaia Cathedral Membership Registration Form

Member Information

Full Name

Address

This address will receive a confirmation email

Home Phone

Cell Phone

Date of Birth

Place of Birth

Currently Employed?

Yes No

Profession

Place of Employment

Highest Level of Education

Which of the following ministries/activities are you interested in?

Bible Study Children Ministries Youth Ministries Assyrian Language School Choir Ladies Auxiliary Parish Committee Other

Spouse

Full Name

This address will receive a confirmation email

Cell Phone

Place of Birth

Date of Birth

Currently Employed? Yes No

Profession

Place of Employment

Highest Level of Education

Which of the following ministries/activities are you interested in? Bible Study Children Ministries Youth Ministries Assyrian Language School Choir Parish Committee Other

Children

Please include the following information for each child (20 years old or younger): 1. Full Name 2. Date of Birth 3. Place of Birth 4. Email Address (if applicable) 5. Cell Phone (if applicable)

Child #1 Information

Child #2 Information

Child #3 Information

Child #4 Information

Child #5 Information

Membership Tier

Select one

Oath of Allegiance to the Holy Apostolic Catholic Assyrian Church of the East

I willfully pledge my allegiance to the Holy Apostolic Catholic Assyrian Church of the East, His Holiness the Patriarch, and to the decisions/decrees of the Holy Synod. I accept all doctrines, dogmas, and the holy Synodical canons taught and enacted by this Church. I am aware that any and all donations, pledges, and bequests I may make to my parish, or any other parish of the Assyrian Church, henceforth belong perpetually and irrevocably to the Holy Apostolic Catholic Assyrian Church of the East.

I agree I don't agree

Mar Zaia Cathedral Membership Registration Form

Description

Please Fix the Following