McKenzie Bible Fellowship Directory Form

* Indicates required field

Your Name *

First

Last

Spouse *

First

Last

Names of Children Living at Home *

Street Address *

Line 1

Line 2

City

State

Zip Code

Country

Mailing Address (if different) *

Line 1

Line 2

City

State

Zip Code

Country

Mobile Number *

Home Number *

Spouse's Mobile Number *

Your Email *

Spouse's Email *

Your birth date *

Spouse's birth date *

anniversary *

Please do not include the following in the directory. *

Home Phone Mobile Phone Email Address Street Address

Preferred contact method for regular church communications. (finance reports, announcements) *

Text to Mobile Email Call to Home Phone Call to Mobile Phone Prefer to not be contacted

Preferred contact methods for emergency church communications. (weather cancellations, emergency meetings, etc.) *

Text to mobile Email Call to Home Phone Call to Mobile Phone Prefer not to be contacted

Include me through the following means when prayer is requested. *

Text to Mobile Email Voice call to Home Phone Voice call to Mobile Prefer not to be included

Submit

9:30 am prayer • 10 am worship

45061 McKenzie Highway • Walterville, Oregon 97489
541.896.3829 • info@mckenziebible.com