Member Profile Update Version 2

Member Profile

Please provide your information so that we can verify and/or update your information in our Membership Database. You can provide information using this form or get a paper copy of this form from the church office. Paper copies can also be returned to the church office. We thank you in advance for your time, commitment and spirit in completing this task. Please print clearly and complete the form and return by December 31, 2018.

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* 1. Profile Information

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

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* 2. Envelope Number

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* 3. Please provide your phone numbers.

Home Phone

Work Phone

Mobile Phone

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* 4. Please place a check beside the preferred number for ROBO calls

Home Phone

Work Phone

Mobile Phone

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* 5. Birthday - Please provide this information to help us with our monthly birthday lists and to determine demographic data for our church.

Birthday

Date

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* 6. If under 18 years of age, please provide your Parents'/Guardian's Name

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* 7. Marital Status

Married

Single

Separated

Divorced

Other (please specify)

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* 8. Name of Spouse

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* 9. Children in Household (under 18 years old)

First and Last Name of Child, Date of Birth (MM/DD/YYYY)

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* 10. Emergency Contact

Name

Relationship

Area Code and Phone Number