NATIVITY OF THE MOST HOLY THEOTOKOS SERBIAN ORTHODOX PARISH
2148 Michelson Dr., Irvine, CA 92612
Phone: (949) 830-5480 Fax: (949) 830-5480
V. Rev. Blasko Paraklis




PARISHIONER MEMBERSHIP APPLICATION



Name
                                LAST                                            FIRST                                            MIDDLE

Address
                       NUMBER                                                                  STREET


                     CITY                                                    STATE                                                     ZIP

Telephone Number
                                             AREA CODE                                                       PHONE #

Baptismal Date and Church

PATRON SAINT/KRSNA SLAVA

LIST OF FAMILY MEMEBERS
                                                                         HUSBAND                                                WIFE

CHILDREN


I hereby acknowledge that I will abide, support and protect the constitution of the Serbian Orthodox Church; that I will fulfill the condition of having a good reputation of a pious Christian, good citizen and obedient of the by-laws, rules and regulations of the Nativity of the Most Holy Theotokos Serbian Orthodox Parish in Orange County.

This application will be reviewed by the Parish Priest and Parish Executive Board in accordance with rules and regulations of the Serbian Orthodox church in the United States of America and Canada.