Information Survey

Email

This field is for validation purposes and should be left unchanged.

EMAIL ADDRESS: It is important that we have your email, if you have one, so we can contact you with important information when appropriate.

Cell Phone: It is important that we have your cell phone # in order to contact you when needed. (If you do not have a cell phone, please enter 111-111-1111)*

Home Phone: It is important that we have your home phone # especially if you don't have a cell phone. (If you do not have a home phone please enter 111-111-1111)*

Emergency Contact's Cell Phone #

Emergency Contact's Home Phone #

Please type in the relationship of your Emergency Contact person to you? Example: Brother, Sister, Friend, etc.

Is there anything you want to inform the Church leadership about? You can fill out the area below with your comments, suggestions, etc.

Date Submitted*

Information Survey

Please complete the survey below (each person can fill out a separate survey) so the Church leadership can serve you better when making plans on reopening.

This is a secure website so your information is safe.
Thank You for your participation. God’s Blessings!