Information Update

The information you submit below helps us keep our membership information up to date. This helps us compile the list of birthdays and anniversaries as well as send out information regarding church events!

Help Us Keep Information Up to Date

* Indicates required field

Name *

First

Last

Birthday (Month/Day) *

Spouse's Name *

First

Last

Birthday (Month/Day) *

Anniversary (Month/Day) *

Cell Phone *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Kids (Please list name, date of birth including year, and current grade) *

Home Phone *

It is okay for KCN to contact me via phone *

Yes No

Cell Phone *

Email *

It is okay for KCN to contact me via email *

Yes No

Any information provided will not be shared with individuals outside of the church. This is to help keep our records accurate and up to date.

Submit

Help Us Keep Information Up to Date

contact

touching hearts, changing lives