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Faithful Navigator, Faithful Comptroller, and Assembly Meeting Information
Please fill in the following information for your Assembly. Please provide as much information as you can.
Faithful Navigator Information
Faithful Navigator *
Your answer
Address *
Your answer
City *
Your answer
Zip Code
Your answer
Daytime Phone Number *
Your answer
Evening Phone Number *
Your answer
eMail Address
Your answer
Member Number
Used to grant access to State Website
Your answer
Birthdate
Used to grant access to State Website
MM
/
DD
/
YYYY
Faithful Comptroller Information
Faithful Comptroller *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Daytime Phone Number *
Your answer
Evening Phone Number *
Your answer
eMail Address
Your answer
Member Number
Used to grant access to State Website
Your answer
Birthdate
Used to grant access to State Website
MM
/
DD
/
YYYY
Assembly Information
Assembly Number *
Your answer
Assembly Name
Your answer
Assembly Address *
Your answer
Assembly City *
Your answer
Assembly Zip Code *
Your answer
Assembly Meeting Place *
Your answer
Assembly Meeting Day & Time *
Your answer
Assembly Phone Number
Your answer
Assembly Website
Your answer
What bird is pictured? *
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