Membership Application

Name *

First

Last

Email *

Phone Number *

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

Address *

Street Address, City, State, Zipcode

Place & Date of Birth *

Place & Date of Baptism *

Marital Status *

Married (and not separated)
Widowed (including living common law)
Separated (including living common law)
Divorced (including living common law)
Single (including living common law)

Number of Children *

Names of Children

Spouse's Name

Is Spouse Orthodox?

Yes
No

Patron Saint

Were you baptized an Orthodox Christian? *

Yes
No

Your Nationality *

Are you a convert to Orthodoxy? *

Yes
No

If yes, provide date, church, city & state

Former Church Affiliation

Have you previously been a member of a Church School Congregation? *

Yes
No

If yes, when and where?

Recommended by: *

Member in good standing (#1)

Recommended by: *

Member in good standing (#2)

"I swear by Almighty God and with my honor that I will, as an Orthodox Christian, obey, respect, fulfill, protect and defend the Holy Canons, laws, traditions, regulations, orders of the Holy Orthodox Church and my Diocesan Bishop; and as a member of the St. Elijah Serbian Orthodox Church School Congregation and of my Parish Church, the St. Elijah Serbian Orthodox Church in Aliquippa, PA. I will regularly and devotedly fulfill all duties and obligations prescribed by the Constitution, Rules and Regulations of the Serbian Orthodox Church in the United States of America and Canada, and the By-laws prescribed by this Church-School Congregation, so help me God!" *

First Name & Last Name of Applicant