New Member Information Form Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country The above information will be listed in the private MAPC online directory, along with a photograph of you/your family. Please indicate below any information that you do NOT wish to have included in the directory. Date of Birth MM DD YYYY Baptized Yes No Married Yes No Education/Degree & School 1 Education/Degree & School 2 Education/Degree & School 3 Occupation/Job Title Employer Membership Information Received by: Letter of Transfer Reaffirmation of Faith First Public Profession of Faith Baptism & Public Profession of Faith If you want a Letter of Transfer, please provide the following so we can write for it: Include church name, Pastor name, street address Family Information Include names of spouse/partner, children's names, ages, and baptism status Emergency Contact Information Name, phone number, relationship How did you hear about MAPC? Thank you!
