On-Line Sign Up'02

STLM CFM MEMBERSHIP ON-LINE REGISTRATION
You want to join CFM, but haven't yet - Why Not?
Fill out the form below - we will contact you [;-)
Any Questions? ... Call Brenda Argano's cell # 863.1905

YES, You can still register & get in a group
Please register NOW.
We are closing registration soon!

Don't miss the Fun & Rewarding CFM activities - Register TODAY!

Please complete the form below and "Submit" it ONCE only. Include both "Hers" & "His" emails and full contact details so that we can stay in touch and update you throughout the CFM year.

Mail your $35 check to:
    STLM CFM - Brenda Argano
    c/o Beavens Systems Inc.
    2200 Pacific Coast Highway # 307
    Hermosa Beach, CA 90254

After you have submitted your completed form, you should see a "THANK YOU" page. After that, you can continue to review the material here on our STLM CFM website.

When you complete the form and click on "Submit" it will format and then send your information via a normal internal web e-mail to us. When we receive this information, your membership data will be entered, and your membership will be effective upon the receipt of the annual dues.

Membership benefits include:

Participation in the total CFM experience

A one year subscription to the CFM Newsletter, ACT

The current program book
Service and assistance from Federation, Area and National Leaders

All the fun stuff and good work CFM does here at STLM!

CFM MEMBERSHIP FORM

Today's Date* :	please use "mm/dd/yy" format example: 09/05/02 (September 5, 2002)

His First Name* :
His Last Name* :

Her First Name* :
Her Last Name* :

Address Line 1* :	(Include Unit or Apt #)
City* :	If "other" please fill in 2nd box:
State* :
Zip Code* :	If "other" please fill in 2nd box:

Home Phone* :	- - 310 - 555 - 1212 style Indicate Type: his/her, wk, cell, pager, etc.
Other Phone :	- - 310 - 555 - 1212 style Indicate Type: his/her, wk, cell, pager, etc.
Other Phone :	- - 310 - 555 - 1212 style Indicate Type: his/her, wk, cell, pager, etc.
Primary Email* :	Indicate Type: his/her, wk, hm, etc.
Other Email :	Indicate Type: his/her, wk, hm, etc.
Year First Joined CFM* :
Member Last Year?* :	yes no
Dues* :	other amount:
Your Check Number :	(if you have it now)

Parish* :	if "other" please fill in 2nd box:
Parish City* :	if "other" please fill in 2nd box:

His Religion* :
His Occupation* :

Her Religion* :
Her Occupation* :

Marital Status/Year Married* :

Child 1 Age :	Name: B-day:mm/DD/yy
Child 2 Age :	Name: B-day:mm/DD/yy
Child 3 Age :	Name: B-day:mm/DD/yy
Child 4 Age :	Name: B-day:mm/DD/yy
Child 5 Age :	Name: B-day:mm/DD/yy

Talents :	- Enter talents to share with CFM: (Remove/Replace all this text)
Other Activities:	- Enter other ministries, church activites or outreach activities you are presently invoved with (if any): (Remove/Replace all this text)
WHY CFM?:	- We're glad you are joining CFM. What do you want to get out of your experience in CFM? (Remove/Replace all this text)
Anything Else:	- List anything else you would like to share with us. (Remove/Replace all this text)
Other Comments :	- Other comments: (Remove/Replace all this text)

* = Required Entry

This page was last updated on 04/06/07.