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Holy Protection of the Mother of God
Orthodox Christian Church
1500 W. Sam Houston Parkway North, Ste. 104
Houston, TX 77043
Tel:713.461.1551
Cell:713 725.3182
Membership Form 2005
Name: _______________________________
Address: _______________________________
_______________________________
Phone #: _______________________________
E-mail: _______________________________
Name and Birth Date of Baptized Orthodox Christian (or Catechumen) Family Members in Household
________________________________ ______________________________
________________________________ ______________________________
________________________________ ______________________________
________________________________ ______________________________
Please respond within 14 days and enclose $30 per baptized soul.
($25 is for our archdiocese and $5 is for our parish)
Make checks payable to Holy Protection, specifying Membership 2005.
If financially you are unable to contribute, please fill out the form,
and inform Fr. Iulian you are unable to contribute at this time.
Thank you in advance for your cooperation. May God bless you.
To print this form, click here for MW Word format, and here for Adobe pdf.
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