The LA Family Membership Form
Greetings

Thank you for taking the time to complete this form.

The LA Family is an online bible and fellowship group, committed to encouraging one more person to read God's word daily.

We want to support you with your decision to read the word of God more. Please complete this form to help us achieve that, your details are for the sole use of our operations within the LA Family and will not be given to any third party.

About You
Name *
Your answer
Family Name *
Your answer
Gender *
Location *
Please tell us where you are based i.e. City/Town, State and Country
Your answer
Email *
Your answer
Mobile No *
Your answer
BBM Pin
Your answer
Social Media profiles *
Please provide the usernames for FACEBOOK and TWITTER so we can ensure we are following you on twitter and/or have connected with you on Facebook.
Your answer
Special Dates *
Please tell us your Date of Birth - DAY / MONTH only please, and any other special dates e.g. Wedding Anniversary
Your answer
About You and The LA Family
Are you... *
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