1. Personal Information

“Now, therefore, you are no longer strangers and foreigners, but fellow citizens with the saints and members of the household of God” Eph 2:19

St. Mary Coptic Orthodox Church
Congregation Registry Form for Year 2009

Registration is for Saint Mary Church's Congregation only. Please type all information. The form must be completed in every detail. Answer “N/A” for all items that do not apply to you.

Note: * = This is a required field

* 1. Number of Members in your Household (including yourself):

* 2. Head of Household/or Youth Living Independently:

* 3. Permanent Address:

* 4. Phone Information:

* 5. Cell Phone Provider (will be used for text messaging)

* 6. E-mail address:

* 7. Occupation::

* 8. Date of Birth:

* 9. Place of Birth:

* 10. If Born Outside the U.S.A, Date of Immigration to the USA:

* 11. Previous Church attended in Egypt & in the USA (name of church & city/state) :

* 12. Date Joined St. Mary Church of East Brunswick:

* 13. Are You Currently a Member of any other Church Besides this Church?

* 14. If Yes, How Often do you Attend Services in this Church?

* 15. Father of Confession:

* 16. Marital Status:

* 17. Which liturgy does your family attend? (check all applies):

* 18. Visitation availability (check all applies):

* 19. Do you receive the Church mail?: