Church Directory Information Form

Please print clearly with Capital letters

Entry with asterisk is required to be filled


Last Name* (姓):.................................First Name* (名):...............................中文姓名:

Email* (电邮):

Home Phone* (家庭电话):

Mobile Phone(移动电话):

Wechat ID(微信号):

Last Name (姓):..................................First Name (名):...............................中文姓名:

Email(电邮):

Mobile Phone(移动电话):


Wechat ID(微信号):

Last Name (姓):..................................First Name (名):...............................中文姓名:

Last Name (姓):..................................First Name (名):...............................中文姓名:

Last Name (姓):..................................First Name (名):...............................中文姓名:

Last Name (姓):..................................First Name (名):...............................中文姓名:

Last Name (姓):..................................First Name (名):...............................中文姓名:

Last Name (姓):..................................First Name (名):...............................中文姓名:


Home Address (家庭住址):
Street* (街,路):...................................Apt. No(公寓号码):

City* (城市):......................................State* (州):........................................Zip Code* (邮编):

Picture Attachment. Size limit is 5MB: 上半身近身照 Cose-up upper body portrait.

 

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