JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Contact information
Complete this form to:
Receive Cornerstone Bible Church emails (prayer requests and general announcements).
Be included in our church directory
Make any changes or additions to your contact/family information.
Questions? Email cbcoffice@cornerstonewichita.org or call 316-838-0400 Tues - Fri.
** Please click the
SUBMIT
button
at the bottom
to complete form. Thank you! **
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name
*
Your answer
Street Address, City, Zip
Your answer
Cell Phone Number
Your answer
Home Phone Number (If different)
Your answer
Birthday
Your answer
Spouse Name
Your answer
Spouse Email
Your answer
Spouse Phone Number
Your answer
Spouse Birthday
Your answer
Child 1 Name
Your answer
Child 1 Gender
Choose
Male
Female
Child 1 Birthday
Your answer
Child 2 Name
Your answer
Child 2 Birthday
Your answer
Child 2 Gender
Choose
Male
Female
Child 3 Name
Your answer
Child 3 Birthday
Your answer
Child 3 Gender
Choose
Male
Female
Child 4 Name
Your answer
Child 4 Birthday
Your answer
Child 4 Gender
Choose
Male
Female
Child 5 Name
Your answer
Child 5 Birthday
Your answer
Child 5 Gender
Choose
Male
Female
Child 6 Name
Your answer
Child 6 Birthday
Your answer
Child 6 Gender
Choose
Male
Female
Include in Directory?
Choose
Yes
No
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
