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Membership Form
Please complete this form (one form per household) if you are a new member or to provide us with new information if you are an existing member. Keeping your information updated enables us to keep you informed. Thank you!
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Email
*
Your email
Date you/your family joined the church (if you are a new member)
MM
/
DD
/
YYYY
First Name
*
Your answer
Last Name
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Street Address 1
*
Your answer
Street Address 2
Your answer
Apartment #
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Wedding Date (If applicable)
MM
/
DD
/
YYYY
Spouse First & Last Name
Your answer
Spouse Date of Birth
MM
/
DD
/
YYYY
Spouse Email Address
Your answer
Child 1
First and Last Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Child 2
First and Last Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Child 3
First and Last Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Child 4
First and Last Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Child 5
First and Last Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Child 6
First and Last Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Do you give BCWC permission to contact you?
*
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No
A copy of your responses will be emailed to the address you provided.
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