540-869-2348

Church Member Contact Information Form

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[av_heading heading=’Please fill in the information below so that we may update our church records.’ tag=’h3′ link=” link_target=” style=’blockquote modern-quote modern-centered’ size=’30’ subheading_active=’subheading_below’ subheading_size=’13’ margin=” padding=’0′ icon_padding=’10’ color=” custom_font=’#ffffff’ icon_color=” show_icon=” icon=’ue800′ font=” icon_size=” custom_class=” id=” admin_preview_bg=” av-desktop-hide=” av-medium-hide=” av-small-hide=” av-mini-hide=” av-medium-font-size-title=” av-small-font-size-title=” av-mini-font-size-title=” av-medium-font-size=” av-small-font-size=” av-mini-font-size=” av-medium-font-size-1=” av-small-font-size-1=” av-mini-font-size-1=”][/av_heading]

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[av_contact title=” button=’Submit’ on_send=” sent=’Thank you. Your information will be added to our church directory.’ link=’manually,http://’ captcha=’active’ captcha_theme=’light’ captcha_size=’normal’ captcha_score=’0.5′ email=’office@stephenscityumc.org’ from_email=’jmoore@stephenscityumchurch.com’ subject=’Church Directory’ autoresponder_email=’jmoore@stephenscityumchurch.com’ autoresponder_reply_to=” autoresponder_subject=” autorespond=” form_align=” color=” heading_tag=” heading_class=” alb_description=” id=” custom_class=” aria_label=” av_uid=’av-kk5omy6r’ admin_preview_bg=”]
[av_contact_field label=’Names’ type=’text’ options=” check=’is_empty’ width=” multi_select=” av_contact_preselect=” av_uid=’av-f5uvzu’][/av_contact_field]
[av_contact_field label=’ Names of children or others living in household’ type=’textarea’ options=” check=” width=” multi_select=” av_contact_preselect=” av_uid=’av-dfx5xm’][/av_contact_field]
[av_contact_field label=’Address’ type=’textarea’ options=” check=’is_empty’ width=” multi_select=” av_contact_preselect=” av_uid=’av-bx0s8q’][/av_contact_field]
[av_contact_field label=’Home Phone’ type=’text’ options=” check=’is_empty’ width=” multi_select=” av_contact_preselect=” av_uid=’av-ai6sm2′][/av_contact_field]
[av_contact_field label='(Name) Cell Phone’ type=’text’ options=” check=” width=” multi_select=” av_contact_preselect=” av_uid=’av-93z3ga’][/av_contact_field]
[av_contact_field label='(Name) Cell Phone’ type=’text’ options=” check=” width=” multi_select=” av_contact_preselect=” av_uid=’av-71dp2i’][/av_contact_field]
[av_contact_field label=’E-Mail Address 1′ type=’text’ options=” check=’is_email’ width=” multi_select=” av_contact_preselect=” av_uid=’av-5o8d2y’][/av_contact_field]
[av_contact_field label=’E-Mail Address 2′ type=’text’ options=” check=” width=” multi_select=” av_contact_preselect=” av_uid=’av-3js3ai’][/av_contact_field]
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