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Today’s Date


Envelope No.
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(If you do not know your envelope number, please call the Clerk’s Office (313.898.3325) Mon – Fri for assistance.)

Full Name (first, middle, last)

Address

City

State

Zip

Home Phone No.

Mobile Phone No.

Work Phone No.

Email

Birthdate

Year Joined

Which Pastor

Do you attend Sunday School?

Which Class

What is your age group?

What Deacon’sGroup are you a member?

What church auxiliaries or committies are you a member?

Immediate family who are members here:

Is it okay if we have your picture on file?

OCCUPATION . SKILL SET

HOBBIES

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