Members Contact Card

Please fill out one card per household.

Your name *

Last name

Email address *

Phone number *

Phone type

MobileHomeWorkOther

Address

HomeWorkOther

Country

Country

Street address

Apt/unit/box (optional)

City

State

Postal code

Birthdate

Marital status

Select…SingleMarriedWidowed

Anniversary date

Household members

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I am interested in getting connected with:

Nursery

Children's Ministry

Youth Ministry

ONE Connect (Young Married Couples Ministry)

Impact Ministries (Outreach)

Help for the Homeless

Women's Ministry

Men's Ministry

Music Ministry

Life Groups

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