Anaheim Young People Contact Information Form

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Please complete as full as possible the information being requested. This information is not distributed beyond the purposes related to the church life.

Last Name *

(your last name)

First Name *

(your first name)

Middle Name

(or English name if different)

I am a *

Brother/Sister *

Full Names of those in your household (e.g. spouse, children, parents, etc) *

Please include the full names of your Spouse, Young People in your household (if you're a YP list your parents full names).

Small Group you meet in *

Name of the small group you and also your young person is a part of (if the young person is not in a small group, please indicate that is the case)

District *

Other:

Language you meet in for the church gatherings *

English

Chinese

Korean

Spanish

Vietnamese

Other:

School(s) of the young person(s)

(e.g. Acaciawood, Cypress High, Oxford, and Home-school)

Mobile Number of Dad

Mobile Number of Mom

Mobile Number(s) of Young Person(s)

e.g. Full Name of YP 123-456-7890

Home Phone

Email of Dad

Email of Mom

Email of Young Person(s)

Home Address

Submit

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This form was created inside of Church in Anaheim.