Josephine Member Update Name * First Name Last Name Birthdate * MM DD YYYY Residential Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Mailing Address If different than above Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Number (###) ### #### Email Are you Married? * Yes No Spouse's Name First Name Last Name Spouse's Birthdate MM DD YYYY Spouse's Phone Number (###) ### #### Spouse's Email Anniversary MM DD YYYY Are you a Member of FBC Josephine? * Yes No When did you become a member? MM DD YYYY How long have you attended FBC Josephine? MM DD YYYY Have you been Baptized? Yes No When were you Baptized? MM DD YYYY Which church were you Baptized though? Is anyone in your home attending Sunday School or Small Groups? * Yes No Does anyone in your home attend: Kids Kingdom JOY Thank you for submitting your member udpate. Please contact Info@fbcjosephine.org for any further questions.
