Get Connected

Let's get connected! Please fill out the form below so we can get to know you, and indicate if you would like to be included in the Church Phone and Photo Directory. Please email a family photo (with a list of individuals in order) to dawnellebills@hotmail.com. The directory is used to help us connect better with one another as a church family. Information in the church directory will only be used for church purposes and will not be sold or given to other organizations.

If you do not wish to have certain information part of the directory, please leave that space blank. If you have more than 3 children as a part of your family, please fill in their information in the large text box at

I would like to receive the weekly church email: *

No Yes (click below)

Click here to email Pastor Dwayne requesting to be added to the email list.

I have emailed a family photo to dawnellebills@hotmail.com *

Yes I do not wish to submit a picture

Person #1 Name: *

First

Last

Family Role: *

Birthdate: (i.e. January 1, 2021) *

Wedding Anniversary: (i.e. January 1, 2021) *

Person #1 Cell Number: *

Person #1 Email: *

I give permission for my photo/video to appear on the church website, social media, other media forms and printed publications. (i.e. Annual Report) *

Yes No

Person #2 Name: *

First

Last

Family Role: *

Birthdate: (i.e. January 1, 2021) *

Person #2 Cell Number: *

Person #2 Email: *

I give permission for my photo/video to appear on the church website, social media, other media forms and printed publications. (i.e. Annual Report) *

Yes No

Family Role: *

Birthdate: (i.e. January 1, 2021) *

Person #3 Email: *

I give permission for my photo/video to appear on the church website, social media, other media forms and printed publications. (i.e. Annual Report) *

Yes No

Birthdate: (i.e. January 1, 2021) *

I give permission for my photo/video to appear on the church website, social media, other media forms and printed publications. (i.e. Annual Report) *

Yes No Option 3

Person #5 Name: *

First

Last

Family Role: *

Birthdate: (i.e. January 1, 2021) *

Person #5 Cell Number: *

Person #5 Email: *

I give permission for my photo/video to appear on the church website, social media, other media forms and printed publications. (i.e. Annual Report) *

Yes No

For Additional Family Members please include the following:

First and Last Name
Family Role: individual, parent, child
Birth date
Cell phone number
Email address
Permission for the individual's photo/video to appear on the church website, social media, other media forms and printed publications. (i.e. Annual Report)

Additional Family Member's Information *

Get Connected

Church Directory Information Form