Newark United Methodist Church Census Form

Newark United Methodist Church Census Form

Help us update our records. Please fill out for each member of your household.
1. Person 1

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Zip CodeCountry
Remove from church rolls?

NoYes
E-mail
Is this the primary email for the family?

YesNo
Phone (Cell Phone Preferred)

Area CodePhone Number
Birth Date

MonthDayYear
2. Person 2

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Zip CodeCountry
Remove from church rolls?

NoYes
E-mail
Is this the primary email for the family?

YesNo
Phone (Cell Phone Preferred)

Area CodePhone Number
Birth Date

MonthDayYear
3. Person 3

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Zip CodeCountry
Remove from church rolls?

NoYes
E-mail
Is this the primary email for the family?

YesNo
Phone (Cell Phone Preferred)

Area CodePhone Number
Birth Date

MonthDayYear
4. Person 4

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Zip CodeCountry
Remove from church rolls?

NoYes
E-mail
Is this the primary email for the family?

YesNo
Phone (Cell Phone Preferred)

Area CodePhone Number
Birth Date

MonthDayYear
5. Person 5

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Zip CodeCountry
Remove from church rolls?

NoYes
E-mail
Is this the primary email for the family?

YesNo
Phone (Cell Phone Preferred)

Area CodePhone Number
Birth Date

MonthDayYear
6. Person 6

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Zip CodeCountry
Remove from church rolls?

NoYes
E-mail
Is this the primary email for the family?

YesNo
Phone (Cell Phone Preferred)

Area CodePhone Number
Birth Date

MonthDayYear
7. Person 7

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Zip CodeCountry
Remove from church rolls?

NoYes
E-mail
Is this the primary email for the family?

YesNo
Phone (Cell Phone Preferred)

Area CodePhone Number
Birth Date

MonthDayYear
Should be Empty: