**Contact information received from this form will be in the next Church Directory**

This is a form to submit your current contact information
so that we can update the church directory.

Please enter your contact information below.
If you have more than 1 entry per field, please separate them with a comma.
Please enter birthdays in Parentheses after each name (i.e. - Name (MM\DD\YYYY) )
(This will only be submitted to the Pastor)
 

Name:
Child(ren):
Address1:
Address2:
Phone:
Cell:
Email:
Email (Alt):

Anniversary: