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Peace Lutheran Church + Waunakee, WI
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Name #1 (First, Middle, Last)
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Your answer
Cell Phone
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Home Phone
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Address (Including city/zip)
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Email Address
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Date of birth
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Have you been baptized?
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No
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If you were baptized, what was the date? (if known - month/year)
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Have you been confirmed?
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Occupation & Place of Employment (if applicable)
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Work Phone
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Name #2 (First, Middle, Last)
Your answer
Cell Phone
Your answer
Address (Including city/zip)
Your answer
Email Address
Your answer
Date of birth
*
MM
/
DD
/
YYYY
Have you been baptized?
Yes
No
Clear selection
If you were baptized, what was the date? (if known - month/year)
Your answer
Have you been confirmed?
Yes
No
Clear selection
Occupation & Place of Employment (if applicable)
Your answer
Work Phone
Your answer
What would you like the staff at Peace to know about your household?
Your answer
Which words describe your family unit?
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Single
Single with Child/Children
Widowed
Couple without Child/Children
Couple with Children
Retiree(s)
Other:
Marriage Date (if applicable)
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