Name *

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Date of Birth *

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Address

Address 1

Address 2

City

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Home Phone

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Spouse's Name

First Name

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Interested In:

Nursery Ministry

Children's Ministry (PreK-5th grade)

Student Ministry (6th-12th grade)

Young Adults Ministry

Men's Ministry

Women's Ministry

Worship & Arts Ministry

Technical Team (Media, Lighting, etc.)

First Impressions (Usher, Greeter, etc.)

Outreach

Would you like to be notified about church events? *

Yes

No