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Denomination
Denomination - please specify
Use the shortest, commonly-used name for the denomination of your church. Do not use acronyms. Country specifiers at the end of the name like, ‘of Australia’, should be left off. Also leave off designators like ‘evangelical’ and ‘charismatic’, unless they are a part of the denomination's official name.
Church name
The name people usually use. If your church has multiple congregations, just type the name of the overall church; leave off congregation names and service times.
Church suburb
Suburb in which the church office is physically located. If outside
WA
please specify state/country.
Future contact
Would you like to receive our newsletter?
Please specify
No
Yes
How would you like to receive it?
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Email
Would you like to receive our prayer letter?
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No
Yes
How would you like to receive it?
Post
Email
Would you like to hear about special events?
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No
Yes
Your Details
Title*
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Mr
Mrs
Ms
Miss
Dr
other
please specify:*
First name*
Put husband name first and separate with an &
Surname*
Email
Mobile phone
Preferred daytime phone number*
Same as mobile
Are you affiliated with a church?
-
No
Yes
Church denomination
Church name
Postal address
Street / PO Box
Suburb
State
-
NSW
NT
QLD
SA
TAS
VIC
WA
ACT
outside Australia
please specify:
Postcode
Country
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