Directory Update Form

Please help us update the Church's directory by filling out the form below. This information is strictly for our records and will not be sold to any other party. Thank you for your help.

Family Name

State Zip
Anniv. Date
Street Address
City
Home Phone
Check here if you don't want phone # listed in directory


Please indicate membership status next to each name. Example: Gregory - RA
M=Member, CM=Child Member, NM=Non Member, RA=Regular attender, WR=Winter Resident, SR=Summer Resident

Head of Household First Name
D.O.B.
Work Phone
Cell Phone
E-Mail (required)

Spouse First Name
include last name if different
D.O.B.
Work Phone
Cell Phone
E-Mail

Child(ren's) First Name
include last name if different
D.O.B.
Work Phone
Cell Phone
E-Mail

Child(ren's) First Name
include last name if different
D.O.B.
Work Phone
Cell Phone
E-Mail

Child(ren's) First Name
include last name if different
D.O.B.
Work Phone
Cell Phone
E-Mail

Child(ren's) First Name
include last name if different
D.O.B.
Work Phone
Cell Phone
E-Mail

Please list all ministries that each family member is involved with, and in what capacity.