Church Directory Form

COLLEGE CHURCH MEMBER INFORMATION FORM

Before You Begin:

We would like all College Church members to provide an individual or family portrait for our pictorial directory. Do you have one to attach to this form (even a selfie)?*

Please use an image that is less than 4MB and appropriate for the directory (image must already be on the device you use to complete this form).*

I understand, and I'm ready to proceed.

We'd be happy to take your portrait for our directory. Please contact the church office to schedule an appointment.

I understand, and I will contact the church office

The information you provide on this form will be used solely to update the College Church database. Only your portrait and name(s) will be included in our church pictorial directory.*

I understand

ADULT #1

This will be the first name listed in our membership directory.

Name*

First NameLast Name

Gender*

Preferred Phone Number*

Area CodePhone Number

This preferred number is my:*

Secondary Phone Number

Area CodePhone Number

This secondary number is my:

Preferred E-mail*

Do you want to be on the church email list to stay informed on church events (usually just a couple of emails a week)?*

YesNo

Mailing Address (ignore that it says street address below—this should be where you get mail)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Is your street address different from your mailing address?*

YesNo

Street Address (if different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Birthdate*

MonthDayYear (type 1000 if you're shy)

College Church Involvement*

Marital Status*

Would you be willing to share your wedding anniversary with us?*

YesNo

Wedding Anniversary*

MonthDayYear (type 1000 if you're shy)

Number of dependent children now in this household (including college-aged) *

Select if you agree:*

I give permission for images of myself and/or my family to be used by the College Church for its pictorial directories and website.

Click "Choose File" to upload a portrait (no larger than 4MB) of yourself for our church pictorial directory.*

Upload a File

SPOUSE

This will be the second name listed in our membership directory.

NAME OF SPOUSE*

First NameLast Name

Gender*

Preferred Phone*

Area CodePhone Number

This preferred number is my:*

Secondary Phone

Area CodePhone Number

Preferred E-mail*

Does your spouse want to be on the church email list to stay informed on church events (usually just a couple of emails a week)?*

YesNo

Is the spouse's address info the same as the Head of Household?*

Mailing Address (if different from Head of Household; ignore that it says street address below—this should be where you get mail)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Street Address (if different from Head of Household)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Birth Date*

MonthDayYear (type 1000 if you're shy)

College Church Involvement*

Select if you agree:*

We give permission for images of our family to be used by the College Church for its pictorial directories and website.

Click "Choose File" to upload a portrait (no larger than 4MB) of you and your spouse for our Church Pictorial Directory*

Upload a File

NAME OF CHILD #1*

First NameLast Name

Gender*

E-mail (if they have one)

Birth Date*

MonthDayYear

College Church Membership*

Name of School/College*

Grade Level for 2025–26*

NAME OF CHILD #2*

First NameLast Name

Gender*

E-mail (if they have one)

Birth Date*

MonthDayYear

College Church Membership*

Name of School/College*

Grade Level for 2025–26*

NAME OF CHILD #3*

First NameLast Name

Gender*

E-mail (if they have one)

Birth Date*

MonthDayYear

College Church Membership*

Name of School/College*

Grade Level for 2025–26*

NAME OF CHILD #4*

First NameLast Name

Gender*

E-mail (if they have one)

Birth Date*

MonthDayYear

College Church Membership*

Name of School/College*

Grade Level for 2025–26*

Click "Choose File" to upload a portrait (no larger than 4MB) of the family members you listed above for our church pictorial directory.*

Upload a File

Help us know who's who in your portrait! Please type the names and a way to identify them. For example: Alex - blue shirt; Lisa - flower in hair.*