Adults - no kids - C3 Church Wynyard

Contact Details Update - Adults no kids

* Indicates required field

Suffix (Mr, Mrs, etc) *

First Name *

Surname *

DOB (dd/mm/yyyy) *

Mobile Number *

Email *

Spouse's Suffix *

Spouse's First Name *

Spouse's Surname *

Spouse's DOB (dd/mm/yyyy) *

Spouses Mobile Number *

Spouse's Email *

Address *

Suburb *

Postcode *

Home Phone Number *

Postal Address (if different) *

Postal Suburb *

Postal Postcode *

Preferred Contact Method(s) *

Phone Call Text Message Email Private Facebook Message

Other Social Media: *

Are you currently employed? *

Place of employment: *

Are you currently studying? *

Educational Institution: *

Course: *

Other Comments *

I give permission for my BASIC details to be shared with church members (i.e. in a public church directory) *

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