Adult Membership Information Form

This form is intended to be filled out as part of the First Connect class at Our Savior's Way.

Your Full Name (including title)(*)
Please let us know your name.

Address(*)
Invalid Input

Street, City, State Zip code

Home phone
Invalid Input

Cell phone
Invalid Input

Work phone
Invalid Input

Preferred phone(*)
Invalid Input

Home Email(*)
Please let us know your email address.

Work Email
Invalid Input

Preferred Email(*)
Invalid Input

Employer
Invalid Input

Job description
Invalid Input

Birth place
Invalid Input

Birth date(*)
/ / Invalid Input

Father's name
Invalid Input

Mother's maiden name
Invalid Input

 
Previous church
Invalid Input

Baptized?(*)
Invalid Input

Place baptized
Invalid Input

Confirmed?
Invalid Input

Place confirmed
Invalid Input

Are you a Thrivent member?
Invalid Input

Marital status(*)
Invalid Input

Date widowed or divorced
/ / Invalid Input

Spouse's name
Invalid Input

Date married
/ / Invalid Input

Place married
Invalid Input

Emergency contact (non-spouse):

Full name
Invalid Input

Relationship
Invalid Input

Phone number
Invalid Input

Email
Invalid Input

Address
Invalid Input

 
List names and information for any children living at home.

Child's name
Invalid Input

Birth date
/ / Invalid Input

School grade
Invalid Input

Gender
Invalid Input

------------------

Child's name
Invalid Input

Birth date
/ / Invalid Input

School grade
Invalid Input

Gender
Invalid Input

------------------

Child's name
Invalid Input

Birth date
/ / Invalid Input

School grade
Invalid Input

Gender
Invalid Input

------------------

Child's name
Invalid Input

Birth date
/ / Invalid Input

School grade
Invalid Input

Gender
Invalid Input

 
Pleas answer a few brief questions about serving God through Our Savior's Way. Please also fill out the separate Time and Talents form so that we may suggest places for you to get involved. (One for each family member grade 8 to adult.)

In what church activities/ministries have you served previously?
Invalid Input

In what other activities/ministries are you interested in serving?
Invalid Input

If you could do anything for God without fear of failure, what would it be?
Invalid Input

List any gifts, skills, training, education, or other factors that may help us match your abilities with ministries here?
Invalid Input

Any additional comments that you would like to make
Invalid Input

Thank you for letting us get to know you more by filling out this form! This information is solely for church use. You may access your personal information at any time via the members-only section of the website. Follow the instructions to receive log on information.

Security Check(*)
Security Check
  RefreshInvalid Input

Contact Information

43115 Waxpool Road, Ashburn, VA 20148
Ph: 703-858-9254
This email address is being protected from spambots. You need JavaScript enabled to view it.
Prayer requests: This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Sunday Worship Services

8:00 AM – Traditional
9:30 AM – Traditional (1st, 3rd Sundays)
9:30 AM – Contemporary (2nd, 4th Sundays)
11:00 AM – Contemporary

Holy Communion celebrated at all services
Nursery available Sundays 7:45AM – Noon

9:30 AM – Bible Study and Sunday School

11:00 AM - Bible Study

Our Mission

The mission of this church is to reach broken and hurting people with the saving and healing message of Jesus Christ.