Directory form

Directory Contact Information
All data gathered is for the operations of Good Shepherd and will never be distributed or shared for any non-church purpose.

Household Name (for grouping)
First Name Last Name
Adult's Full Name
First Name Middle Name Last Name Suffix

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone Number
- Area Code Phone Number
Preferred Name/ Nickname
Gender

Male Female
Birth Date
Month Day Year
Occupation/Profession
Marriage Date
Month Day Year
Cell Phone Number
- Area Code Phone Number
Work Phone
- Area Code Phone Number
E-mail
Check as appropriate

Baptized? Confirmed Episcopalian?
Communications

Weekly E-Blast?
Should be Empty: