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UPDATE YOUR INFORMATION

Use the form below to let us know of any changes to your information.

Please note that if you are only changing part of your information, we still require you to enter your previous address, name, birthday, email, and phone number to help confirm your identity.

Please allow up to a week for processing.

(Your privacy is important to Cornwall Church. We do not share your personal data with Cornwall Attenders or other companies)
PERSONAL INFORMATION
 

First Name:

Last Name:

New Last Name:

(if changed)

Birthday:

(mm/dd/yy)

Marital Status:

Spouse Name:

Spouse Birthday:

Anniversary Date:

(mm/dd/yy)

 
ADDRESS
 

Current Street Address:

City:

Zip:

 

Current Mailing Address:

(if different than street address)

City:

Zip:

 

New Street Address:

(if changed)

City:

Zip:

 

New Mailing Address:

(if changed)

City:

Zip:

 
CONTACT INFORMATION
 

Home Phone

(xxx-xxx-xxxx)

Work Phone:

(xxx-xxx-xxxx)

Cell Phone:

(xxx-xxx-xxxx)

E-mail Address 1:

E-mail Address 2:

 
CHILD INFORMATION (OPTIONAL, IF MORE THAN 4 PLEASE CONTACT THE OFFICE AT (360) 733-2150)
 

Child Name:

Child Birthday:

Grade:

 

Child Name:

Child Birthday:

Grade:

 

Child Name:

Child Birthday:

Grade:

 

Child Name:

Child Birthday:

Grade:

 
OTHER INFORMATION:
(Please use this area for letting us know of any other information that may need to be corrected.)

 

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