ON-LINE MEMBER DIRECTORY INFORMATION

Hope Lutheran Church of Warren ~ 32400 Hoover Road ~ Warren MI 48093

586-979-9055 www.hopelutheranwarren.com

Rev. 2017-07

NAME (Family-Last Name) ______

Address______City ______

State ______Zip______Home phone ____/____-______

Adult/Parent 1: Name ______Cell phone ______/ ______-______Text (Y/N)

E-Mail: ______Date of birth - Show (Y/N) ___/___/___ Year Not required

Adult/Parent 2: Name ______Cell phone ______/ ______-______Text (Y/N)

E-Mail: ______Date of birth - Show (Y/N) ___/___/___ Year Not required

Anniversary ______Show (Y/N)

Child 1: Name ______Cell phone ______/ ______-______Text (Y/N)

E-Mail: ______Date of birth - Show (Y/N) ___/___/___ Year Not required

Child 2: Name ______Cell phone ______/ ______-______Text (Y/N)

E-Mail: ______Date of birth - Show (Y/N) ___/___/___ Year Not required

Child 3: Name ______Cell phone ______/ ______-______Text (Y/N)

E-Mail: ______Date of birth - Show (Y/N) ___/___/___ Year Not required

List Additional Family Members on the Back – Return this form to: Merte or Earl or Caradonna or Pawlowski Mailboxes, or scan and email back to:

This is an “On-Line” directory. By signing below you agree to have the above information posted on-line.

This Directory is a secured access Directory, only accessible by approved members with password.

FORM REQUIRED TO ACCESS ONLINE DIRECTORY

If you do not wish this information posted on line, check this box.

If you wish to update the “paper copy” of Church Directory, check this box.

Please sign here______Date______

Adult/Parent 3: Name ______Cell phone ______/ ______-______Text (Y/N)

E-Mail: ______Date of birth - Show (Y/N) ___/___/___ Year Not required

Adult/Parent 4: Name ______Cell phone ______/ ______-______Text (Y/N)

E-Mail: ______Date of birth - Show (Y/N) ___/___/___ Year Not required

Anniversary ______Show (Y/N)

Child 4: Name ______Cell phone ______/ ______-______Text (Y/N)

E-Mail: ______Date of birth - Show (Y/N) ___/___/___ Year Not required

Child 5: Name ______Cell phone ______/ ______-______Text (Y/N)

E-Mail: ______Date of birth - Show (Y/N) ___/___/___ Year Not required