Membership Transfer Form

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This field is for validation purposes and should be left unchanged.

Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Transferring To*

Transferring From *

Church Address:*

Church Phone Number:*

Pastor's Name*

Please list additional family members included in this transfer (if applicable):

First Last

I authorize Mountain View Seventh-Day Adventist Church to request and process the transfer of my membership.

Yes

Name

First Last

Date