MEETING MEMBERSHIP RECORD

PHILADELPHIA YEARLY MEETING

 

_____________________________Monthly Meeting
_____________________________Quarterly Meeting

Member's full name _________________________________________

Previous names _____________________________________________

Date of birth ____________ Place of birth __________________

Date of adoption ______________________________

Date of admission ___________________

__ By birth __ By application__ By certificate of transfer from
_________________________ Monthly Meeting

Father's name ______________________________________________

Mother's name ______________________________________________

Addresses [Year Street City State Zip]

_______ ____________________________________________________

_______ ____________________________________________________

_______ ____________________________________________________

_______ ____________________________________________________

_______ ____________________________________________________

Date of termination ______________

___ By death ; place of burial _____________________________

___ By resignation ___ By release

___ By certificate of transfer to __________________________

Monthly Meeting


Comments:
____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

Marriage Record

To whom married:____________________________________________________

Date:_________ Place _______________________________________

Spouse
Date of birth________ Place ________________________________

Membership(where)___________________________________________

Father's name ______________________________________________

Mother's name ______________________________________________

Date of death _______________ Date of divorce ______________

Children

Name _______________________________________________________

Date of birth____________ Place ____________________________

Date of adoption ___________________

Date of marriage________ To ________________________________

Full member ____ Associate member ____ Non-member ____

Name _______________________________________________________

Date of birth____________ Place ____________________________

Date of adoption ___________________

Date of marriage________ To ________________________________

Full member ____ Associate member ____ Non-member ____

Add more sheets as necessary