EmailMe Form - LCC Census 2014

Name *
First Last
Age Range *
Email *
Phone
### - ### - ####
Address

Street Address City State / Province / Region Postal / Zip Code
Marital Status *
Single
Married
Spouse Info (if applicable)
Name
First Last
Age Range
Email
Phone
### - ### - ####
Census Questions
Fill out the number of children you have in each age group

0-1 Year

2 Years

3 Years

4 Years

5-6 Years

7-8 Years

9-11 Years

12-17 Years (youth)

Put "0" in any age grouping above for which you have no children
How many Sundays per month do you typically attend LCC? *
Are you involved in an LCC Small Group? *
Yes
No
Would you consider yourself to be actively serving in a ministry at LCC? *
Yes
No
Have you gone through the LCC Membership process? *
Yes
No
What best describes you/your family? *
I consider LCC my home church
I visit LCC, but consider another church my home
I visit LCC, but don’t consider any church my home church