Use this form to have us add, delete, or change directory information. Just fill in the parts that matter and hit the submit button. The information will be sent via e-mail to us and we will make the changes as quick as possible. This listing will always be up-to-date if everyone will keep us informed of mistakes and changes. Be sure to leave us your name (the one submitting the changes) in case we need more information.

My name is
and I would like to submit the following changes for the Orange Street membership information data base
OR add to or modify those on our Prayer List.

Please make the following changes to the:
Membership Directory
Prayer and Sick List (Bottom of Page)

New or Change DIRECTORY Information
PLEASE FILL IN ALL APPLICABLE INFORMATION

Name:    Birthday:
Spouse:    Birthday:
Wedding Anniversary:
Street Address:
Mail Address:
City, ST : Zip:

Phone Number:
E-Mail Address:
Child 1:   Birthday:
Child 2:   Birthday:
Child 3:   Birthday:
Child 4:   Birthday:

Alternate Winter Visitors DIRECTORY Information

Summer Address:
City, ST : Zip:

Phone:

New or Modify PRAYER & SICK LIST information

Who is sick:
Where are they (home; a hospital; etc.):
Sickness or problem:
Relationship to congregation (friend of; former member; etc.):
Contact for more info (name & phone):

Additional Comments: