New Member Application

Serra Club of Erie

New Member Application (Online Version)

The New Member Application form below can be completed and submitted online.

Serra Club of Erie New Member Application

Date Submitted

Sponsor's Full Name

Applicant Information

First Name

Last Name

Middle Initial

Home Address

City

State

Zip

Primary Phone

Phone Type

Email Address

What attracted you to the Serra Club of Erie?

Parish Information

Parish Name

Pastor's Full Name

Parish Address

City

State

Zip

Spouse Information

First Name

Last Name

Middle Initial

Is your spouse a member?

Home Address

City

State

Zip

Primary Phone

Phone Type

Email Address

Emergency Contact (Relative not residing with you)

First Name

Last Name

Middle Initial

Home Address

City

State

Zip

Primary Phone

Phone Type

Relationship

The below information will be obtained following the initial review of your application

Applicant's Signature

Pastor's Signature (Applicant is responsible for obtaining this signature)

Received by (Board Member)

Board Member Signature

Date Membership is Approved

Thank You!

Your application has been successfully submitted.

The Serra Club

of Erie, Pennsylvania

New Member Application

Serra Club of Erie

New Member Application (Online Version)

The New Member Application form below can be completed and submitted online.

Serra Club of Erie New Member Application

Applicant Information

Parish Information

Spouse Information

Emergency Contact (Relative not residing with you)

The below information will be obtained following the initial review of your application

Applicant's Signature

Pastor's Signature (Applicant is responsible for obtaining this signature)

Received by (Board Member)

Board Member Signature

Date Membership is Approved