EmailMe Form - Register with the Community / Update Contact Info

Name *

First Last

Name on Emmaus event (if different from above)

First Last

Your Emmaus* event (community name and event #) *

*Equivalent 3-Day Movement organizations include Cursillo, Koinonia, Kairos, Tres Dias, Via de Cristo, and Vida Nueva; please indicate the community name & location, event type, and event designation (e.g. number, date, etc.).

Phone *

### - ### - ####

Date of Birth

MM / DD / YYYY

Please provide if you are comfortable doing so. This information is used only to determine eligibility for serving on a Face to Face Encounter team (Face to Face team members are to be at least 55 years old).

Home Address

Old Email Address

New Email Address

Community emails you wish to receive

ALL

Community Notices only

Prayer Requests only

Remove name from emailing list?

No

Yes

Comments