CPC Members & Friends

CPC Members & Friends

Partner Information
Your Name *

First Name Last Name
Your Birthday

Month Day Year
Date Date Picker Icon
Your Email
example@example.com
Your Cell Phone Number
Partner’s Name

First Name Last Name
Partner Birthday

Month Day Year
Date Date Picker Icon
Partner Email
example@example.com
Partner Cell Phone Number
Anniversary

Month Day Year
Date Date Picker Icon

Address

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

Children
Child 1

First Name Last Name
Birthday 1

Month Day Year
Date Date Picker Icon
Phone Number 1
Child 2

First Name Last Name
Birthday 2

Month Day Year
Date Date Picker Icon
Phone Number 2
Child 3

First Name Last Name
Birthday 3

Month Day Year
Date Date Picker Icon
Phone Number 3
Child 4

First Name Last Name
Birthday 4

Month Day Year
Date Date Picker Icon
Phone Number 4

Church Information
In what year did you and family join CPC?
Leave blank if not a member
Elder Service CPC and elsewhere

Have you ever served as an Elder?
Deacon Service CPC and elsewhere

Have you ever served as a Deacon?
Ministry Interest 1
Ministry Interest 2
Ministry Interest 3

Other
Anything else useful to know?
Should be Empty:

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