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G.R.A.C.EMMAUS

(Greater Rose Area Community Emmaus)

ONLINE COMMUNITY INFORMATION UPDATE

Your Name:

Spouse's Name:

Address:

City:

State:

Zip:

E-mail Address:

Home Phone:

Work Phone:

Church:

Denomination:

Church Address:

State:

Zip:

City:

I made my:

Do you meet regularly in a reunion?

Where at, and what time?

Would you like to receive the G.R.A.C.E. Newsletter by Mail?

Ext.:

RED FIELD DESIGNATOR Denotes as required information

Church Phone:

Use TAB Key to move between fields.

Personal

Information

Church

Information

Community:

Walk No.:

Date:

Walk Information

I submit that the above information is correct to my knowledge and that I am willing to serve my Lord in what ever capacity is needed on the Team.

The above information is to be used solely by the directors of the G.R.A.C.E. Walk to Emmaus to verify the information contained in our database that is used to produce the G.R.A.C.E. Directory, the mailing lists for the newletter either by mail or E-Mail, for the E-Groups, and other lists of team and volunteers, or other uses as authorized by the board. We presently have approximately 1500 listings. It is believed that many of these are inaccurate or incomplete. Futhermore to reduce the newsletter mailings to only those that are reading, making use of the newsletter and who are not in other communities. To accomplish our goals we need your help. This information is only for the benefit of our Emmaus Community and is not divulged or used for any other purposes.

Include Area Code

MM/DD/YYYY

Would you like to receive the G.R.A.C.E. Newsletter by E-Mail?

Are you a member of the Clergy?

Are you a member of the G.R.A.C.E. E-Groups?

Community Information & Survey

Would you like to be a member of the G.R.A.C.E. E-Groups?

Would you like to be removed from the G.R.A.C.E. E-Groups?

Would you like to be removed from the G.R.A.C.E. Directory?

Would you like to be removed from all G.R.A.C.E. Lists?

Signature:

Date:

1. People NEW to the GRACE Community Area, you should enter ALL Necessary Information.

2. For GRACE Members Change only the personal information that has changed since your Walk.

3. If you are a GRACE Member but have worked other communities, enter only those other WALKS WORKED.