Koinonia Fellowship

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Family Names and Directory Update:

Please fill out this form if you have recently had address, phone or email address changes. Also, if you have recently had a baby and we do not have the latest information. Thank you.

First Name

Last Name

Street Address

City

State

Zip Code

Home Phone (including area code)

Birth Date

Your Email

Spouse's Name

Spouse's Birth Date

Spouse's Email

You only need to include children under 18 who are currently living with you. Thank you.

Child1

Birth1

Allergies1

Child2

Birth2

Allergies2

Child3

Birth3

Allergies3

Select YES if you'd like to be included in the Koinonia Fellowship Directory (printed) YesNo

If you have additional children, please submit an additional form with just your first and last name, and the names and information about your other children. Thank you.