Membership Status Update

Name(s) of members of the household

Mailing Address

Preferred Phone(s)

Preferred Email(s)

Select the one that best applies:

• Continue as a Member
• Change to Associate Member (for those who wish to remain on the mailing list and are part time residents, or whose primary membership is with another church)
• Transfer Membership* (Please add the name and location of the new church below)
• Remove from Membership
• Request contact from Pastor Sue Jones

*If you are transferring your membership, please add the name and location of your new church.

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