Directory Information Request

It has been over 10 years since we last updated our church directory. It is important that we keep our contact information updated so we are able to reach each other when we need information or to encourage each other through trials or illness.

“Therefore encourage one another and build each other up, just as in fact you are doing.” -1 Thessalonians 5:11.

After all information is gathered, a directory will be printed and distributed to the church.

If you have any questions on this form, please contact us.

Name *

First

Last

Publish Information to Church Directory *

• Yes
• No

You can choose to have the information on this form be published to the church directory. If you opt to be entered into the directory, you can omit certain pieces of information by unchecking the corresponding checkbox.

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Address

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Show Address in Directory

• Show Address in Directory

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Home Phone

Show Home Phone in Directory

• Show Home Phone in Directory

Layout (copy) (copy)

Cell Phone

Show Cell Phone in Directory

• Show Cell Phone in Directory

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Email

Show in Email in Directory

• Show in Email in Directory

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Birthday (Month/Day Only)

Show in Birthday in Directory

• Show in Birthday in Directory

When you are unable to attend a church service, would you feel comfortable receiving a follow-up call from a church member?

• Yes, I would appreciate a follow-up call.
• No, I prefer not to receive a follow-up call.
• I am open to receiving a follow-up call occasionally.

What is your preferred method of contact from the church?

• Phone Call
• Text Message
• Email
• WhatsApp
• Other (Please Specify)

Preferred Contact Method (Other)

Additional Family Members

Do you have an additional member to add to the directory?

• Yes

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Name (Additional Family Member)

First

Last

Show Name in Directory (Additional Family Member)

• Show Name in Directory

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Cell Phone (Additional Family Member)

Show Phone in Directory (Additional Family Member)

• Show Phone in Directory

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Email (Additional Family Member)

Show Email in Directory (Additional Family Member)

• Show Email in Directory

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Birthday (Additional Family Member)

Show Birthday in Directory (Additional Family Member)

• Show Birthday in Directory

Would you like to add a child under the age of 18?

• Yes

All dependents ages 18 or over should fill out the form individually.

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Name (Child 1)

Show Name in Directory (Child 1)

• Show Name in Directory

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Birthday (Child 1)

Show Birthday in Directory (Child 1)

• Show Birthday in Directory

Would you like to add another child under the age of 18?

• Yes

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Name (Child 2)

Show Name in Directory (Child 2)

• Show Name in Directory

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Birthday (Child 2)

Show Birthday in Directory (Child 2)

• Show Birthday in Directory

Would you like to add another child under the age of 18?

• Yes

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Name (Child 3)

Show Name in Directory (Child 3)

• Show Name in Directory

Layout (copy) (copy)

Birthday (Child 3)

Show Birthday in Directory (Child 3)

• Show Birthday in Directory

Would you like to be added to the church email list?

• Add Just My Email Address to the Church Email List
• Add All Email Addresses on this Form to the Church Email List
• Not Interested

Our church email list is used to share news, announcements, and the church bulletin.

Submit