Church Directory

Name*
First Last
Spouse
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Don't list my address
- Only check here if you DO NOT want your address listed in the church directory
Phone*
Cell Phone (for office use)
Don't list my phone number
- Only check here if you DO NOT want your phone number listed in the church directory
His Email
Her Email
His Birthday
MM slash DD slash YYYY
Her Birthday
MM slash DD slash YYYY
Marital Status
Date of Wedding Anniversary
MM slash DD slash YYYY

Children living at home:

First & Last Name	Birthday