LCM INFORMATION UPDATE
IMPORTANT: Please help us update our database by completing the following. Please complete a separate survey for EACH member in the household. If you have family members/children who no longer live at your address, we need their updated information also. Call Michelle Kalin, Connections Coordinator at the Church office if you have questions.
Worship Services/Campuses You Attend (check all that apply):
Household Member for this Survey: *
FULL Legal Name (first, middle, last) *
Your answer
Preferred First Name
Your answer
Complete Home Address (street, apt. #, city, state, zip code) *
Your answer
Alternate Address (plus dates)
Your answer
Household Phone (xxx) xxx-xxxx *
Your answer
Is this phone unlisted?
Cell Phone (xxx) xxx-xxxx
Your answer
Is this phone unlisted?
Work Phone + Ext. (xxx) xxx-xxxx Ext. xxx
Your answer
Is this phone unlisted?
Email Address
Your answer
Gender *
Date of Birth (mm/dd/yyyy) *
MM
/
DD
/
YYYY
Baptism Date (mm/dd/yyyy) - If month/day unknown, use 01/01 and year.
MM
/
DD
/
YYYY
Place of Baptism (Church, City, State)
Your answer
Confirmation Date (mm/dd/yyyy) - If month/day unknown, use 01/01 and year.
MM
/
DD
/
YYYY
Place of Confirmation (Church, City, State)
Your answer
Marital Status
Wedding Date (if applicable) mm/dd/yyyy
MM
/
DD
/
YYYY
Maiden Name (if applicable)
Your answer
Employer (if applicable)
Your answer
Occupation (if retired, include previous occupation)
Your answer
School, if a student (include grade level)
Your answer
Hobbies, Special Interests, Activities
Your answer
Special Health Considerations & Allergies (Type NA if none or not applicable) *
Your answer
Other Relatives at LCM? Who? How are you related? (Type NA if none or not applicable) *
Your answer
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