EmailMe Form - Church Directory Form

Family Name *

Home Phone

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

Physical Home Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Mailing Address (if different from physical address)

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Head of Household's Name *

Cell Phone

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

Email

Membership Status *

Communicant Member

Baptized Member

Non-Member

Birthday (Month/Day) *

Spouse's Name *

Enter "None" if unmarried.

Cell Phone

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

Email

Membership Status *

Communicant Member

Baptized Member

Non-Member

Not applicable (unmarried)

Birthday (Month/Day) *

Child's Name

First Last

Cell Phone

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

Membership Status

Communicant Member

Baptized Member

Non-Member

Birthday (Month/Day)

Child's Name

First Last

Cell Phone

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

Membership Status

Communicant Member

Baptized Member

Non-Member

Birthday (Month/Day)

Child's Name

First Last

Cell Phone

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

Membership Status

Communicant Member

Baptized Member

Non-Member

Birthday (Month/Day)

Child's Name

First Last

Cell Phone

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

Membership Status

Communicant Member

Baptized Member

Non-Member

Birthday (Month/Day)

Additional Children's Names

Include first name, cell phone (if any), Email (if any) membership status (C =Communicant, B=Baptized, N=Non-member), Birthday (Month/Day)