INFORMATION FOR THE 2019 CHURCH DIRECTORY
When this form is completed, click this button.
The information will be sent ONLY to Sue Creevey to use for the 2019 Church Directory.  
No information will be used for any other purpose.
Date of Birth is for Church records only and will not be in the directory.
In this section, please enter information for
all the people at the same address that attend our church.
Last Name
First Name
Last Name
First Name
Last Name
First Name
Last Name
First Name
Last Name
First Name
Last Name
First Name
Address
City
State
Zip Code
Land Line Home Phone #
In this section, please enter information for each person
Last Name
First Name
Cell Phone
OK to Text?
Email Address
Day
Year
Month
Date of Birth:
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Last Name
First Name
Cell Phone
OK to Text?
Email Address
Day
Year
Date of Birth:
Month
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First Name
Last Name
Cell Phone
OK to Text?
Email Address
Year
Day
Date of Birth:
Month
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Last Name
First Name
OK to Text?
Cell Phone
Email Address
Date of Birth:
Day
Year
Month
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First Name
Last Name
Cell Phone
OK to Text?
Email Address
Date of Birth:
Month
Day
Year
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Last Name
First Name
Cell Phone
OK to Text?
Email Address
Month
Year
Day
Date of Birth: