Liturgical Minister Information Form

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Today's Date REQUIRED Please fill out this field. Please enter valid data.

Are you/your family a registered member at Christ the Good Shepherd? REQUIRED Yes No Please fill out this field.

Address/Apt # REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Home Phone REQUIRED Please fill out this field. Please enter valid data.

Cell Phone REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Are you over the age of 18? REQUIRED

We simply need to know if you are over 18 for Safe Environment purposes. Anyone of any age is able to serve in our ministries.

Yes No Please fill out this field.

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