Membership Application Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Last NameFirst NameMaiden Name or Middle InitialPhoneEmailLocal Address, Street Address, City and Zip CodeNorthern Address, Street Address, City and Zip CodeBirthdateWedding DateBaptism DateSpouse/PartnerGender, Maile/FemaleChildrens Names, Birthdates, and Grade LevelIf Veteran, Service Branch and Years ServedAffiliate Home Church and AddressReceived into Membership as a Regular Member?Confessions of Faith?Reaffermation of Faith?Letter of Transfer?If Transfer, from which Church, Address, Phone and EmailMembership Shepherd NameA current member of the Church will be paired with you to answer questions, provide a friendly face at church, help make introductions, and help you find your calling at Lely PresHobbies/Special InterestsHow did you first hear about Lely?WebsiteDrive ByInvited by a friendSocial MediaGoogle SearchOtherWhat do you find most attractive at Lely?Church Offices HeldIf you are or have been an ordained Elder or Deacon in the Presbyterian Church, please indicate where and when you were ordained and where you served.DropdownFirst ChoiceSecond ChoiceThird ChoiceSingle Line TextChristian EducationTeacherVacation Bible SchoolLead a Book Bible StudyMusicChoirHandbellsSoloistOfficeComputerMailingsSocial MediaOutreachVisit MembersStephen MinistryMission ProjectsGroupsLead a GroupMen's GroupOtherBuildings & GroundsCarpentryElectricalPaintingChild CareChildren's MessagePre-schoolThird ChoiceWorshipUsherGreeterLiturgistSpecial EventsKitchenSeasonalPrayer ChainYouth WorkScoutingPizza ThursdaysPlanning EventsPublic RelationsSpeakingWritingSocial MediaPress ReleaseSignageSubmit
