Church Member/Attender Information Update

Please fill out this form and click submit.

Please fill this out thoroughly to include all family members. Thank you. if you are filling out information and it says optional, please still provide that information if it applies to you. Thanks.

Today's Date

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Parents/Adults in Household

Adult 1 Name (First, Last, Nickname)

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Email

*

This address will receive a confirmation email

Home Phone

Cell Phone

*

Address

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Birthday

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Anniversary

Relationship Status

*

Please select all that apply.

Single Widowed Married Separated Divorced

Church Status

*

Please select one option.

Member Attender Visitor

Place of Employment

Adult 2 Name (First, Last, Nickname)

Email

Home Phone

Cell Phone

Birthday

Anniversary

Relationship Status

Please select all that apply.

Single Widowed Married Separated Divorced

Church Status

Please select all that apply.

Member Attender Visitor

Place of Employment

Child Information

This section is for children that currently live in your household

Child Name 1 (First, Last, Nickname)

Birthday & Age

Grade Level child will be in for the 2022-2023 School Year

Please select all that apply.

Babies Toddler Preschool K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th

Daycare, Preschool, or Regular School Child Attends

Does your teenager have a job?

Please select all that apply.

yes no Option

If yes, where?

Child Name 2 (First, Last, Nickname)

Birthday and Age

Grade Level Your Child will be in for the 2022-2023 School Year

Please select all that apply.

Babies Toddler Preschool Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th

Daycare, Preschool. or Regular School Child attends

Does your teenager have a job?

Please select all that apply.

yes no

If Yes, where?

Child 3 (First, Last, Nickname)

Birthday & Age

Grade Level child will be in for the 2022-2023 school year

Please select all that apply.

babies toddler preschool kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th

Daycare, Preschool, or Regular School Child attends

Does your teenager have a job?

Please select all that apply.

yes no

If yes, where?

If your child is in college and lives at home when not at school, please provide the following information: Name, Birthday & Age, College Attends and Year they are, do they have a job? If so, where?

For more than 3 children, please write all the above information here:

For all other information, write here:

Description

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