Member Information Form

* Indicates required field

First Name *

Preferred Name *

Middle/Maiden Name *

Surname *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Cell Phone Number *

Email *

Birth Month *

Birth Day *

Birth Year *

If married, please list Spouse's Name and Anniversary Date *

Do you have children? *

Yes No

Date & Place of Baptism *

Are you a member of another church? *

Yes No

If Yes, please list Church Name and Address *

Employment Status *

Occupation/Profession *

Hobbies & Interests *

If Yes, please list your child(ren)'s names, date(s) of birth, date(s) and place(s) of baptism (if applicable), grade level and school, and hobbies and interests *

Upload Photo *

Max file size: 9MB

Submit

Visit

217 South Church Street
Salisbury, NC 28144-4927

Church Office Hours
08:30 a.m. — 5:00 p.m. (Mondays-Fridays)

worship

Sundays
08:30 & 11:00 a.m.

Contact us

Office: 704.636.3121
Fax: 704.637.2933
Email: mark@fumcsalisbury.org

Our mission is to make and nurture Christian disciples through the presence and power of God.