IRM Membership Form Revised

"Life Touching Life with Eternity in Mind"

IRM Membership Form

Todays Date: * +

Marital Status (Check One): *

Married

Divorced

Single

Widowed

Last Name: *

First Name: *

Date of Birth: * +

Street Address: *

Apt #:

City: *

State: *

Zip Code: *

Home #: *

Cell #: *

E-mail: *

Spouse Last Name:

Spouse First Name:

Spouse Date of Birth:

Wedding Anniversary: +

*If you have joined this ministry and are under the age of 18 years old, you are considered a minor, we are required to have your parents/legal guardians contact information.

Last Name:

First Name:

Home / Cell #:

Gender (Check One):

Male

Female

Have You Been Baptized? (Check One): *

Yes

Date of Baptism: +

Name of Church previously attended:

City:

State:

EMERGENCY CONTACT INFORMATION

Any medical conditions we should be aware of?

Is this person a (Check One): *

Member

Persuing Membership

Non-member

Last Name: *

First Name: *

Relationship *

Home #: *

Cell #: *

Children Ages 0 to 17 years that are currently in household:

Last Name:

First Name:

Gender:

Male

Female

Date of Birth: +

Last Name:

First Name:

Gender:

Male

Female

Date of Birth: +

Last Name:

First Name:

Gender:

Male

Female

Date of Birth: +

Last Name:

First Name:

Gender:

Male

Female

Date of Birth: +

Last Name:

First Name:

Gender:

Male

Female

Date of Birth: +

Membership Classes - All members are asked to complete both classes within the first 30 days of joining the ministry. Membership classes must be complete before new members are able to participate in any ministry/auxiliary.

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Invisible Reality Ministries

2700 N. 54th Street Milwaukee, Wisconsin 53210

Phone: 414-231-3363 - Website: www.invisiblerealityministries.org