IMPORTANT: Please help us update our church database by completing the following. Information is used for our various ministries. This update only needs to be completed ONCE, unless information has changed.)

* Update information for ALL members of your household. (Include those who are not active LCM members and note this in comments.)

* Do you have family members/children who no longer live at your address? We need their updated information also in a separate survey.

*If a question doesn't apply or you don't know the answer (ex. Baptism/Confirmation dates/places) and it is not required, feel free to skip the question.

Call Michelle Kalin, Connections Coordinator at the Church office (402.333.4444) if you have questions.

The following information applies to the entire household. If not living in same household, please complete a separate survey.
Worship Services & Campuses You Attend (check all that apply):
Household Emergency Contact Information
Please list one Emergency Contact for the entire family -- preferably from a different address
Notify in Emergency: *
Your answer
Phone (xxx) xxx-xxxx *
Your answer
Relationship: *
Your answer
Other Relatives Who Attend LCM? Who? How are you related? (Type NA if none or not applicable): *
Your answer
Household Address (street, apt. #, city, state, zip code): *
Your answer
Alternate/Snowbird Address (include beginning and end dates):
Your answer
Primary Household Phone (xxx) xxx-xxxx: *
Your answer
Is this phone unlisted?
Household Email Address (if applicable):
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service