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2024 Congregation Information Form
1
2024 Congregation Information Form
Due Date:
March 1, 2024
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2
Completed By
*
This field is required.
First and Last Name:
Please enter your email:
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3
Congregation Information
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
Congregation Name:
Congregation Email:
Congregation Phone:
Congregation Address:
Congregation Fax:
City, State and Zip Code:
Congregation Social Media: (YouTube, Facebook, Twitter, etc...)
Congregation Website:
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4
Clergy-in-Charge
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
Title, First and Last Name:
Please Select
Priest
Deacon
Please Select
Please Select
Priest
Deacon
Ordination Order:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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5
Senior Warden
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
First and Last Name:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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6
Junior Warden
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
First and Last Name:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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7
Treasurer
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
First and Last Name:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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8
Bookkeeper
(If this is a person other than the Treasurer)
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
First and Last Name:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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9
Clerk
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
First and Last Name:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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10
Administrator/Secretary
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
First and Last Name:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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11
Youth Ministry Primary Contact
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
First and Last Name:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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12
Children's Ministry/Sunday School
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
First and Last Name:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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13
Employee Benefits Administrator
(Responsible for administering employee benefits and/or reviewing and approving insurance bills)
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
First and Last Name:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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14
Do you have any additional Clerics to add?
*
This field is required.
YES
NO
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15
How many Clerics do you need to add?
1
2
3
4
5
6
7
8
9
10
1
2
3
4
5
6
7
8
9
10
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16
Cleric #1
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
Title, First and Last Name:
Ordination Order & Position:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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17
Cleric #2
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
Title, First and Last Name:
Ordination Order & Position:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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18
Cleric #3
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
Title, First and Last Name:
Ordination Order & Position:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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19
Cleric #4
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
Title, First and Last Name:
Ordination Order & Position:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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20
Cleric #5
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
Title, First and Last Name:
Ordination Order & Position:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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21
Cleric #6
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
Title, First and Last Name:
Ordination Order & Position:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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22
Cleric #7
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
Title, First and Last Name:
Ordination Order & Position:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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23
Cleric #8
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
Title, First and Last Name:
Ordination Order & Position:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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24
Cleric #9
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
Title, First and Last Name:
Ordination Order & Position:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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25
Cleric #10
Note: It is important that the correct information is provided for each individual for our records. Please do not duplicate all entries.
Title, First and Last Name:
Ordination Order & Position:
Phone Number & Phone Type (home, cell, or work):
Email Address:
Mailing Address:
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person an employee
City, State and Zip Code:
OPTIONAL - Spouse/Partner's Name:
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