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Contact Information for The Gate Directory
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* Indicates required question
Email
*
Your email
Please confirm attendance
I confirm I have been in attendance at The Gate Alliance Church for 6 months or longer.
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FIRST Name
*
Your answer
LAST Name
*
Your answer
FIRST Name
(If married, spouses FIRST Name)
Your answer
LAST Name
(If married, spouses last name if different than yours)
Your answer
STREET ADDRESS
*
(Number and Street address only)
Your answer
TOWN/CITY
*
Your answer
POSTAL CODE
*
(Example: L2E1X9)
Your answer
HOME TELEPHONE (If applicable)
(Example: 905-123-4567)
Your answer
CELL PHONE 1 (If applicable)
(Example: 905-123-9876 - Bob's)
Your answer
CELL PHONE 2 (If applicable)
(Example: 289-987-6543 - Susan's)
Your answer
EMAIL 1
*
(Example:
name1@provider1.com
)
Your answer
EMAIL 2 (If applicable)
(Example:
name2@provider2.com
)
Your answer
Birthdays
(Example: Bob, June 1, 1960 / Susan, October 20, 1962 / Children: Bobby, December 12, 1984)
Your answer
Wedding Anniversary (If applicable)
MM
/
DD
/
YYYY
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