New Member Form

Application for Membership

Welcome to Horeb Family!

We are delighted to have you with us. Please complete the form below so we may process your membership application.

Application for Membership

Household Information

Household Information

First Name

Middle Name

Last Name

Other Names

Birth Date

Mailing Address

City

State

Zipcode

Home Phone Number

Cell Phone Number

Please enter at least one contact number

(Please enter at least one contact number)

Martial Status

Anniversary Date

Home Parish

Home Parish location

Home Town

Family Information

Family Information

Spouse's First Name

Spouse's Middle Name

Spouse's Last Name

Spouse's Other Names

Birth Date

Home Town

Children's Names

Children's Names

1. Child

Child 1

First Name

Last Name

Age

Sex

Birthdate

Grade

2. Child

Child 2

First Name

Last Name

Age

Sex

Birth Date

Grade

3. Child

Child 3

First Name

Last Name

Age

Sex

Birth date

Grade

4. Child

Child 4

First Name

Last Name

Age

Sex

Birth Date

Grade

5. Child

Child 5

First Name

Last Name

Age

Sex

Birth Date

Grade

Declaration

I / We hereby request to become member / members of the Horeb Mar Thoma Church of Los Angeles. I / We agree to abide by the constitution of the Mar Thoma Church and subscribe to the faith and practices of the Mar Thomas Church.

Please attach Letter / Affidavit from your mother parish

Upload File

Have you attached a Letter / Affidavit from your mother parish?

Yes

Please prayerfully consider pledging a contribution to support the ongoing needs of the Church ($ USD)

I/We am/are interested in participating in the following activities:

Missions & Outreach

Choir

Sunday School

Women's Ministry

Other (Contact the office bearers with your interest)

Signature

Date

Signature text

(Please enter your full name and date as your digital signature)

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Application for Membership

Application for Membership

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