membership

Name

Address

Phone

Email

Birthday

Profession / Occupation

Spouse Name

Spouse Birthday

Spouse Occupation

LAITY ONLY

Liberian Church Name

Current Church Affiliation

Current Church Address

CLERGY ONLY

Ordination date as a Deacon

Priest

Diocese of Canonical Residence

Church Employment

Current Church Address

Annual dues per year ( you will be sent to the payment page after submitting this form )

Clergy - $100 Retired Clergy - $50.00 Laity - $50.00

All Members are requested to contribute $100.00 per year towards the Episcopal Church of Liberia Development Fund. "Let us give back to the Church that molded us so that others may benefit."