A4D Team Members Read and sign the declaration of faith Please fill in your registration information. Name * First Name Last Name Prefers to be called Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Date of Birth * MM DD YYYY Gender * Female Male Home Parish St Andrew's Anglican Church - Anchorage, Ak St. Matthew's Anglican Church - Portland, Or El Señor de la Misericordia (Lord of Mercy) Anglican Church - Tualatin, Or Salem Anglican - Salem, Or Light of Christ Anglican Church - Corvallis, Or Christ Our Peace Anglican Church - Spokane, Wa Church of The Resurrection - Moses Lake, Wa Christ Church - Ellensburg, Wa Christ the Redeemer Anglican Church - Kennewick, Wa All Saints Anglican - Federal Way, WA St. Brendan's Anglican Church - Bellingham, Wa Grace by The Sea - Oak Harbor, Wa All Saints Church - Everett, Wa Holy Trinity Edmonds - Edmonds, Wa St. Peter's Anglican Church - Seattle, Wa The Gathering - Port Gamble, Wa St. Charles Anglican Cathedral - Bremerton, Wa St. Erasmus Anglican Church - Burley, Wa St. Ursula Anglican Church - Sultan, Wa Christ Our Hope Anglican Church - Olympia, Wa Iona Community Anglican Church - Vancouver, Wa Parish or mission not listed Name of Parish of not listed Status * Check all that apply Baptized Confirmed Communicant Lay Person Bishop Priest Deacon Place of work * Job title * Work Phone * (###) ### #### Training * Describe any Cursillo, A4D, Walk to Emmaus, or Team training you have completed. Experience * None Rector(a) Core Team Table Team Palanca Rollista Sacristan Kitchen Servant Community Music Rollos given? Most recent weekend Teams When and where Do you attend Weekly Reunion Group? * Yes No Do you attend Monthly Ultreya? * Yes No Music Team * Are you interested in being on the music team? Yes No Any special needs? Food allergies, special diet, regular medication, chronic medial needs. Emergency Contact: Name * First Name Last Name Emergency Contact: Phone * (###) ### #### Thank you! Email Questions to A4D Team