Contact information

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Contact information

Please submit your updated contact info to be used for the Highway Assembly of God directory -- only to be used between the Pastoral and administrative staff and other congregants of our church. The information will be published as a hard copy and given to staff and to the members of the church congregation (*unless noted otherwise). If you choose the option to allow your information to be used for the Pastoral and administrative staff ONLY, but would like for a portion of your information to be used for our church family; please write descriptively in the comment section what you would like withheld from the congregation. What you withhold will NOT be given out publicly to our churchgoers; but utilized for our Pastors and staff ONLY.

Name *

Name of Spouse

Spouse Email

Street Address, City, State & Zip

Home Phone number

Cell Phone Number

Spouse Cell Phone Number

Permission to send out text messages regarding church reminders & events?

Yes - to both myself and my spouse

Yes - but to only me

Clear selection

Birthday

YYYY

Spouse Birthday

YYYY

Wedding Anniversary

YYYY

First Names and ages of children

How would you like your information shared? *

With Pastoral and Administrative Staff Only

With Both Staff and Members of the Congregation

Comments

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