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Your contact info may be out-of-date or incorrect in our records!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.
What is your first and last name? *
Do you live with a spouse and/or children? Please provide names of all who live in your household. *
What is your home address? *
What is your home (landline) number? *
What is your cell phone number? *
What is your spouse's cell phone number? (Please write "N/A" if not applicable.) *
What is your email address? *
What is your spouse's email address? (Please write "N/A" if not applicable.) *
Today's date? *
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