LWCC New Members Information Form
Information submitted will be added to the LWCC Membership Database.
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                                   Welcome to the LIGHT where the LOVE shines BRIGHT!
First & Last Name *
Email Address *
Address *
City / State / Zip Code *
Cell number (with area code) *
Alternate number (with area code)
Birthday *
MM
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DD
/
YYYY
Relationship Status *
Gender
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Membership Status *
May we publish your information in a church directory? *
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