Truth Baptist Church Register

60 Burnham Street, S. Windsor, CT 06074 Phone: (860) 289-8976

Bim Rowley, Pastor

Keith Tower, Executive Pastor / Eli Rodriguez, Youth Pastor	Web:

Please help us to have an accurate record of you and your family. Fill out any information on this sheet that you would like the church to keep in its records. All information will remain confidential. The primary purpose for this register is to help the church clerk prepare an accurate prayer/phone and published calendar list on a periodic basis. Welcome and thank you for your help!

Personal Phone List Contact Information	Start/or Form Date:

____/ ____/ _____

(As you wish to appear)

Last Name: _______________________________

First Names: __________________________________________________

Address: _________________________________

City _______________ State ____	Zip _________

Mailing Address (__ Please keep my local address private):

Address: _________________________________	City _______________ State ____ Zip _______

Phone for List: (______) _____________________ (Please include area code)

If This is a Cell, for Whom? _______________

Do you want your phone number listed on the phone list?	__Yes; __No, please keep it private.

Email: ____________________________________________

Personal Date/Detailed Information

"Call me this" Name

Over for Given Name Chart	Birthday mm/da/*yyyy	Anniversary

mm/da/yyyy	Comments/College Child Attends

*Only at home children Birthdays will appear (Cal.)
H
W
C	*
C	*
C	*
C	*
C	*
C	*
C	*
C	*
C	*
C	*

Any Ongoing Prayer Concerns: _________________________________________________________

L#	Full Name F/M/Last	DOB	Salvation	Baptism	Member	Rededication/*Wedding	Death
H
W
C1
C2
C3
C4
C5
C6
C7
C8
C9
10
11
12
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Other Dates/ Family information: