Directory Update

* Indicates required field.

Name*Please provide your information so we can keep you updated.

First

Last

Address*

Address 1

Address 2

City

State

Postal Code

Country

Phone Number*Enter the best number to reach you

Type of phone*

Cell

Landline

Second Phone NumberAdd another number to reach you

Second phone type

Cell

Landline

Single Select*Please let us know if you are a member or friend of the church.

Member

Friend

Single SelectIf you are a friend of the church, would you like to become a member?

Yes

Spouse’s name with same address

Children’s names with same address

Other relative(s) names with same address

Date

mm/dd/yyyy

White Memorial Church