Church Directory

First Name

Last Name

Cell Phone

Date of Birth

Home Phone

Email Address

Address

City

Country

Zip

State

Preferred method of Contact Preferred method of Contact Email Phone Text

Comments

Baptismal Date

Primary Language

Occupation

Currently enrolled in School? Currently enrolled in School? Yes No

Current School / Grade / Major

Do you have any children? Do you have any children? No 1 2 3 4 5+

If you have children, please list their names and date of births here

Is your membership currently at First University? Is your membership currently at First University? Yes No