EmailMe Form - Disciple Membership Application

General Information

Please note that spouses must submit separate applications, one per individual.

Name *

First Last

Your Email *

Cell Phone *

### - ### - ####

Home Phone

### - ### - ####

Date of Birth *

MM / DD / YYYY

Preferred Method of Contact

Gender *

Home Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Education Level *

Occupation *

Civil Status *

Number of Children *

Spouse's Name (if applicable)

First Last

SACRAMENTS

Baptism *

MM / DD / YYYY

Confirmation *

MM / DD / YYYY

Holy Matrimony

MM / DD / YYYY

INVOLVEMENT IN PARISH AND OTHER MINISTRIES

Parish *

Primary Phone *

### - ### - ####

How long have you been at the parish? *

Please list parish ministries or programs you are involve in *

Please list other Catholic organizations you are involved in, nature of involvement and inclusive years (e.g. K of C, Grand Knight, 1987 to present) *

Please list AFC programs and events that you or your family have participated in and inclusive years (e.g. Family Fest, 1997 up to present) *

Please list any AFC outreach program(s) that you have initiated in your area and inclusive years (e.g. Family Hour, 2000 to 2005) *

Please list talents, skills or areas of expertise *

Please describe your current personal spiritual practices (e.g. weekly rosary, weekly Mass) *

Do you have a spiritual director? *

Yes

No

Please describe your current family spiritual practices: *

Please elaborate on your intention to pursue membership: *

Please tell us:
1. How you found out about the AFC
2. Why you would like to be a Disciple Member

Please upload a recent photo of yourself. *

Only mpg and jpg files will be accepted.

Pastor's Letter of Recommendation & Sacrament Verification with Parish Seal

Name *

Email *

I have asked my Pastor to send a letter of recommendation, complete with a Parish seal (see letter template for couples or for singles) to membership@afc.org to explicitly verify BOTH:

1. That I am a fully practicing Catholic.
2. Records are present for Baptism, Confirmation and (if applicable) Holy Matrimony. *

Yes

I affirm that I have answered all of the above questions honestly and to the best of my ability.

Signature *

Clear

Date *

MM / DD / YYYY

Hidden Field