St. Paul Missionary Baptist Church is updating its membership records; as such, we are asking every member to complete the following form.  Thank you!

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* 1. Your First Name:

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* 2. Your Middle Name:

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* 3. Your Last Name:

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* 4. Your Home Phone (please enter the 10-digit number without spaces or special characters):

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* 5. Your Cell Phone (please enter the 10-digit number without spaces or special characters):

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* 6. Your Work Phone (please enter the 10-digit number without spaces or special characters):

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* 7. Your Email:

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* 8. Your Address:

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* 9. City:

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* 10. State:

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* 11. Zip Code:

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* 12. Your Date of Birth (mm/dd/yyyy):

Birthday

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* 13. Your Gender:

T