Covenant Life Missions International Christian Church
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Church Office: (717) 630-2177 Address: 117 Ruth Ave, Hanover, PA, 17331
Directory Family/ Singles Form
*
Indicates required field
Name
*
First
Last
Head of the Household name First. *Be aware this is the name of what our church family will see when the directory is released.
Birthdate
*
Ex. 8-6-79
Address
*
Line 1
Line 2
City
State
Zip Code
Country
# of additional family members
*
Put all names that live in house hold
List Of Additional Memebers (READ INSTRUCTIONS)
*
If Applicable, Please Fill List Out From Oldest to Youngest with the Birth date recorded after the Like So: Nancy Women (Wife) B: 3-4-78 Beth Teeny (Child) B: 8-2-97 Cutie Pie (Child) B: 5-30-15
Main Number
*
Secondary Number
*
Recieve Updates and Prayer Request via Text Message?
*
Yes
No
Anniversary Date of Spouses (If Applicable)
*
Email
*
Optional
Submit
Home
Our Mission
New To CLMICC
Worship
Events
Leadership
Prayer Request
LIVE!
Messages
CLMICC Blog
Spark Youth Ministries
Contact Info
About the Pastor