Member Yearly Update Form

Date *

Gender *UnknownMaleFemaleOther

Name *

First

Last

Date of Birth *

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Cell Phone *

Email Address

Membership Date

Home Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Have you accepted Jesus Christ? *

• Yes
• No

Have you been Baptized? *

• Yes
• No

Services of interest *

• Sunday School Teacher
• Usher
• Music
• Worship team
• Kitchen
• Men Group
• Youth Ministry
• Cleaning
• Maintenance
• Technology (IT)
• Children Ministry
• Event Planner
• Accounting
• Administrator
• Secretary
• Treasurer
• Women Group
• None

Marital Status *

• Single
• Married
• Divorced
• Separated
• Widow
• Live/Parent
• Other

Gender (partner) *UnknownMaleFemaleOther

Name (partner) *

First

Last

Date of Birth (partner) *

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Cell Phone (partner) *

Email (partner)

Services of interest (partner) *

• Sunday School Teacher
• Usher
• Music
• Worship team
• Kitchen
• Men Group
• Youth Ministry
• Cleaning
• Maintenance
• Technology (IT)
• Children Ministry
• Event Planner
• Accounting
• Administrator
• Secretary
• Treasurer
• Women Group
• None

Family Members

How many children under the age of 18 years old do you have living with you?

• No
• 1
• 2
• 3
• 4
• 5

Child Name 1 *

First

Middle

Last

Date of Birth / Child 1 *

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Child Phone 1

Gender 1 *UnknownMaleFemale

Child Name 2 *

First

Middle

Last

Birth Date Child 2 *

MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Child Phone 2

Gender 2Unknown 2MaleFemale

Child Name 3 *

First

Middle

Last

Birth Date Child 3 *

MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Child Phone 3

Gender 3UnknownMaleFemale

Child Name 4 *

First

Middle

Last

Birth Date Child 4 *

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Child Phone 4

Gender 4UnknownMaleFemale

Child Name 5 *

First

Middle

Last

Birth Date Child 5 *

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Child Phone 5

Gender 5UnknownMaleFemale

Submit