Emmanuel Brinklow

Membership Transfer

Transfer of Membership Form

If transferring to Emmanuel-Brinklow, list the ministries where you might want to serve.

(*) Denotes required fields

New to the Washington Metro Area
Bible Study
Baptism
I need a pastoral staff visit/call (sick family member, counseling).
Transfer my membership to Emmanuel-Brinklow.
Name & address of church transferring from
Transfer my membership from Emmanuel-Brinklow.
Name & address of church transferring to

Contact Information

First Name*:

Last Name*:

Birth Date:

Address*:
City*:		State*:	Zip*:

Home Phone*: ( ) -
Cell Phone: ( ) -	Email*:

Spouse

First Name
Last Name

Birth Date:

Children

First Name Last Name	First Name Last Name
Birth Date:	Birth Date:

First Name: Last Name:	First Name Last Name
Birth Date:	Birth Date:

I would like to serve in the following ministries:
Other request:

NOTE: The Emmanuel-Brinklow Adventist Church does not give any information you submit to third parties. This information is kept confidential and is used solely for the purposes of conducting church business.