Name

First Name

Last Name

CONTACT INFO, ETC

[ Please note that deacons, ministers, staff, and elders will have access to the information you provide below. ]

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Cell Phone

(###)

###

####

May we include your cell phone in the directory?

Email Address

May we include your email address in the directory?

Date of Birth

YYYY

Occupation

Employer/Business

Marital Status

If Married:

Name of Spouse

First Name

Last Name

Anniversary

YYYY

If you have children, please list below:

Name (Child 1)

First Name

Last Name

Date of Birth

YYYY

Grade

LIving at Home?

Baptized?

If yes, what year?

Name (Child 2)

First Name

Last Name

Date of Birth

YYYY

Grade

Living at Home?

Baptized?

If yes, what year?

Name (Child 3)

First Name

Last Name

Date of Birth

YYYY

Grade

Living at Home?

Baptized?

If yes, what year?

Name (Child 4)

First Name

Last Name

Date of Birth

YYYY

Grade

Lilving at Home?

Baptized?

If yes, what year?

MEMBER INFO UPDATE

MEMBER INFO

Is the photo we have on file for you a bit out of date? Let's fix that, shall we?

Send a recent one in a quick email to Katy. Thanks!

INVOLVEMENT OPPORTUNITIES

SERVICES:

Sundays at 8:30 am (A Cappella) & 11:00 am (instrumental)

Bible classes: Sundays at 10:00am

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