Congregation Information Change Form
Type of Change (select all that apply)
*
Name Change
Address Change
Phone Change
Merger
Closed
No longer Church of God
Other
Name of Congregation
*
Previous Name of Congregation if changed
Email
*
example@example.com
Previous Email if changed
example@example.com
IRS EIN
Is this a new EIN?
Yes
No
New Mailing Address
Congregation Mailing Address
Individual Mailing Address
Business Address
Name, if different than the church name
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone Number
*
-
Area Code
Phone Number
Kind:
*
Mobile
Work
Home
Secondary Phone Number
-
Area Code
Phone Number
Kind:
Mobile
Work
Home
Web Address
Fax Number
-
Area Code
Phone Number
Primary Language
Primary Ethnicity
Average Weekly Attendance
Year Established
Staff Members and Position
Other Information/Comments
Submit
Should be Empty: