Verify Your Contact Information
If you would like to stay up to date on church service and activity schedules, please provide your information on this form. Thank you!
Name
*
Address, email and phone number are not required for children under 18 in your household.
Address
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AA
AB
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AL
AP
AR
AS
AZ
BC
CA
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CT
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DE
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FM
GA
GU
HI
IA
ID
IL
IN
KS
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LA
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MB
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MH
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NB
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NV
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OR
PA
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QC
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SC
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TN
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WA
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WV
WY
YT
Email
Mobile Number
If you do not wish to share the year of your birthday, please enter the year as 1900.
Please provide the year for any person under 18 years of age.
Birthdate
*
Anniversary
Salvation Date
Baptism Date
Favorite Bible Verse
Favorite Hymn
*
Submit
Description
If you would like to stay up to date on church service and activity schedules, please provide your information on this form. Thank you!
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