Church Member's Current Contact Info
Your contact info may be out-of-date or incorrect in our records! Beginning this new year of 2021, we are trying to stay connected with you. Please fill out the form with your most recent information.
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What is your first and last name?
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Your answer
Do you live with a spouse and/or children? Please provide names of all who live in your household.
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Your answer
What is your home address?
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Your answer
What is your home (landline) number?
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Your answer
What is your cell phone number?
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Your answer
What is your spouse's cell phone number? (Please write "N/A" if not applicable.)
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Your answer
What is your email address?
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Your answer
What is your spouse's email address? (Please write "N/A" if not applicable.)
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Your answer
Today's date?
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