Husband's Name *

First Name

Last Name

Wife's Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Husband's Cellphone

(###)

###

####

Wife's Cellphone

(###)

###

####

Husband's Birthdate

MM

DD

YYYY

Wife's Birthdate

MM

DD

YYYY

Anniversary

MM

DD

YYYY

Preferred Method of Contact

Cellphone

Text

Email

Interest in church activities include:

Sunday School Teacher/Helper

Nursery

Children's Church

Master Clubs (Wednesday night)

Bus Ministry

Vehicle Maintenance

Choir / Special Music

Grounds

Cleaning

Maintenance

Office

Other