Epworth United Methodist Church Directory Information - Leave blank any entry you do NOT wish to be included.

Name

Street or PO Address

City, State

Zip

Phone number

Email Address

Spouse/Partner Name

Street or PO Address

City, State

Zip

Phone number

Email Address

Listing in directory Listing in directory separately together cross-referenced (if together)

Children

Pets

Picture Picture Epworth photo (we will be in touch with you to schedule) Self-provided (electronically) No photo

Additional Information

I hereby give permission to include in the Epworth Church Directory the information completed above. I hereby give permission to include in the Epworth Church Directory the information completed above. Yes