Pine Island United Methodist Church Member & Friends Contact Information
Please help us by filling in your address and contact information and submit. We are rebuilding our database and church management system so that we can communicate with you in a much more effective manner.
Thanks so much for your help!
Email address *
Gender
Full Name *
Your answer
Preferred Name *
Your answer
Address *
road, city, state, zip code
Your answer
Alternate Address
Please note, if you have a P.O. box, use the ALTERNATE ADDRESS to kindly provide your physical address.
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Marital Status *
Wedding Anniversary Date *
MM
/
DD
/
YYYY
Children Living at Home
Names & Date of birth
Your answer
Baptized
Member of PIUMC?
Do You Attend Worship Regularly?
Home Phone
Your answer
Cell Phone
Your answer
Work Phone
Your answer
Other Email
Your answer
Employer
Your answer
Occupation
Your answer
Retired
Preferred Method of Contact *
Do You Attend a Small Group ?
A group that helps to enhance your spiritual growth and relationship with Jesus, does not have to be a group that meets regularly at PIUMC ?
Your answer
Additional notes
anything extra you might want to include.
Your answer
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