Bethany Member Information Form

Bethany Baptist Church

3417 Rolesville Road
Wendell, NC 27591
(919) 266-3273
email: bethanych@bellsouth.net

Pastor: Phillip Brantley
Youth Pastor: Christian M. Bonham
Music Minister: Mrs Serena Pearce
Organist: Mrs Mildred Perry

Member Information Form

Please use this form to submit or make changes to your member information. Information will be kept in the Bethany Baptist records and will be published in a "Member Information Booklet" which will be distributed to our members. When you "submit" this form, the information provided will be sent to the church secretary.

Name:	email: cell: birthdate (mmm dd): (year):
Home Address/Phone: Input your "home" address, then fill in the P.O. Box (if applicable) for mailings.	P.O. Box (if applicable): Home Phone:
OTHER FAMILY MEMBERS: Please include the following: 1) your spouse if you are married 2) all dependants (children or other) 3) any adult children who also attend Bethany (adult children should also submit their own form to include their spouse/children). (Birthdates are to help with placement in Sunday School classes & activities & will not be shared in the information booklet.)
Spouse:	email: cell: birthdate (mmm dd): (year): anniversary (mmm dd): (year):
	email: cell: birthdate (mmm dd): (year):
	email: cell: birthdate (mmm dd): (year):
	email: cell: birthdate (mmm dd): (year):
	email: cell: birthdate (mmm dd): (year):
	email: cell: birthdate (mmm dd): (year):
Message: (optional message)