Please trans­fer my mem­ber­ship

 To Orchard Park Church From Orchard Park Church

Church transferring To or From (required)

Transfer Name (required)

Your Name (required)

Your Email (required)

Phone Number (xxx-xxx-xxxx) (required)

Your Birthday (xx/xx/xxxx) (required)

Your Address (required)

Spouse's Name

Spouse's Birthday (xx/xx/xxxx)

Anniversary (xx/xx/xxxx)

1st Child

1st Child's Birthday (xx/xx/xxxx)

2nd Child

2nd Child's Birthday (xx/xx/xxxx)

Busi­ness Infor­ma­tion

Busi­ness Name

Type of Busi­ness

Busi­ness Address

Busi­ness Phone Number (xxx-xxx-xxxx)

Busi­ness Email

May we pub­lish your infor­ma­tion in the church directory?
 Yes No

Other Information