Thank you so much for filling out this form. Your data will be used for our internal record; for pastoral use and for important communication from the church leadership. You have the right to request your removal at any time.

Name

First Name

Last Name

Phone Number

Home Address

Date of Birth

Membership Status

Member over 5 years

Member less than 5 Years

Want to become a member

Happy attender

Children/Dependents Under 18

Please give the names and ages of any children or dependents you have

Please tell us if you would like any more information about any area of church life

Database update