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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Suffix
Your answer
Preferred Name
*
Your answer
Home (Physical) Address
(Address, City, State Zip)
*
Your answer
If mailing address is different
(Address, City, State Zip)
Your answer
Home Phone Number
Your answer
Mobile Phone Number
*
Your answer
Work Phone Number
Your answer
Primary Email
*
Your answer
Alternate Email
Your answer
Birthday
(MM/DD/YYYY)
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Marital Status
*
Single
Married
Widowed
Divorced
If married, list spouse's name
Your answer
Family Position
*
Head
Spouse
Have you been baptized?
*
Yes
No
If so, when? (approximate if necessary)
MM
/
DD
/
YYYY
Have you joined the FBC St. Francisville as a member?
*
Yes
No
If so, when? (approximate if necessary)
MM
/
DD
/
YYYY
Would you like to opt into the online directory?
(i.e. have at least your name, phone number, email, and address listed in the directory)
*
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No
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