Member Update Connect Card

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Name

*

Birthday

Email

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Phone

Address

Occupation / Employer

Marital Status

Please select all that apply.

Single Engaged Married Separated Divorced Widowed

Student?

Please select all that apply.

Yes No Graduated

If “Student,” School ?

*

If “graduated,” degree and school

*

Church Membership

Please select all that apply.

Yes No

If “Yes” Church Name

Baptized

Please select all that apply.

Yes No

Family Members in Household (names, relationship, birthday, etc.)

Description

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