Parish Registration & Membership Application • Saint Elias Antiochian Orthodox Church

كنيسة النبي إيليا الأنطاكية الأرثوذكسية – استمارة تسجيل وعضوية الرعية

Welcome to Prophet Elias Antiochian Orthodox Church. This form registers you with our parish and, if you wish, applies for parish membership. A household (husband, wife and their children under 18, or a single parent with children under 18) completes ONE application together, and every family member must be on it: the main applicant, the spouse and every child under 18. Add each person with the Add Another Person button (on our website: Add another family member). Every other person 18 or older completes their own form, including adult children living at home. Spouses who prefer to register separately may each complete their own form. Father reviews and approves every application. Membership takes effect only when you receive written confirmation from the parish. Membership categories and voting rights are defined by the bylaws of Prophet Elias Antiochian Orthodox Church and the regulations of the Antiochian Orthodox Christian Archdiocese of North America.

About this person

This person is *

Primary adult

Spouse

Child under 18

First name *

Middle name

Last name *

Preferred name

Sex *

Date of birth *

Mobile phone *

Tip: Required for the main applicant and spouse.

Email address *

Tip: Required for the main applicant. No email address? Call the church office at (909) 232-5582 and we will register you.

Email address (optional)

Phone (optional)

Baptismal or Patron Saint Name

Feast Day

Household (primary adult only)

Registration type *

Household (husband and wife, with any children under 18)

Single parent with children under 18

Individual adult 18 or older

Household complete *

Everyone registering with me is on this application: my spouse (unless my spouse is filing separately) and all our children under 18.

Tip: Use the Add another family member button to add your spouse and each child under 18 before you submit.

New registration or update *

New registration

Update to my existing record

Member No. (only if you already have one)

Tip: New registrants receive a member number automatically once Father approves the application.

Are your minor children listed on your spouse's form?

Yes

Not applicable

Home address *

Address line 2

City *

State *

ZIP code *

Main language

Second language

Third language

Year-End Statement

Emergency contact (name, relationship, phone)

Membership

Applying for *

Parish membership

Parish Family Member (Non-Orthodox)

Inquirer or Catechumen

Supporter

Marital status *

Date of marriage

Marriage blessed in the Orthodox Church?

Yes

I'd prefer to discuss with Father

Orthodox faith and sacramental life

Ecclesiastical Affiliation *

Other Jurisdiction or Church

Received into the Church By

Reception Date

Reception Church and City

Previous Parish and Priest

Letter of good standing

I understand the parish may request a letter of good standing from my previous parish priest.

Canonical standing

I am not under any canonical or ecclesiastical penalty that bars me from the Holy Mysteries.

Annual Confession and Communion

I intend to receive the Sacraments of Confession and Holy Communion at least once a year, as required for voting membership.

Would you like to learn more about the Orthodox faith or become a catechumen?

Yes

Sunday School interest

Yes

Getting involved

Occupation

Time and talent

Year you first became a parishioner here (if any)

Stewardship

Pledge amounts are not asked on this form. After you submit, the confirmation page links to our pledge page and its Help Me Decide guide.

Stewardship intention

I/we will make an annual stewardship pledge online or on a paper card

I need help or would like to discuss with Father

Communications, directory and privacy

Email updates from the parish

Yes

Text and WhatsApp Consent

Directory Listing

Photo Permission (Adults)

Photo Consent for Children

I would like Father to contact me

Yes

Privacy notice: Your information is used only for parish ministry, pastoral care, communication, stewardship records and the reports our Archdiocese requires. It is seen only by the priest and the parish officers who need it, and is stored with our church-software provider (Tithely). We never sell it. We share it outside the parish only with the Archdiocese, with your consent, or when required by law. Contact the parish office to see or correct your information.

Privacy notice agreement *

I have read and agree to the privacy notice above.

Membership Covenant

I am a baptized and/or chrismated Orthodox Christian. I seek to live my Christian life within the faith, worship, sacramental life and discipline of the Holy Orthodox Church. I will respect the spiritual authority of our parish priest and our hierarchs, the canons and traditions of the Antiochian Orthodox Church, and the bylaws of Prophet Elias Antiochian Orthodox Church. I will support the parish with my time, talents and treasure according to my means. I understand that my application is reviewed by the parish priest and that I become a member only upon written confirmation.

Membership covenant agreement *

I agree to the Membership Covenant above.

Signature

Signature: type your full legal name *

Confirmation *

I confirm the information is true to the best of my knowledge, and as parent or guardian I am authorized to provide information for the children listed.