Directory information

Some information such as photo permission would not be listed but would be for administrative purposes. The information submitted on this form is going directly to Pastor McCormick.

*Family Name (last name)**
Address *
City *
	State *			zip *
E-mail Address: * (required)
Home phone
Family Information
Name		Birthday	(month/day)
Parent #1 -name		birthday		cell phone		email
Parent #2 -name		birthday		cell phone		email
	Anniversary
child #1 -name		birthday
child #2 -name		birthday
child #3 -name		birthday
child #4 -name		birthday

Any other information you would like us to know?
We would like permission to use any photos taken during worship or during any activity connected with Corinth Presbyterian Church for the website. All images would be screened prior to use by either a session member or the pastor.				Photo permission *		yes no
If you answered no to the photo permission, would you mind giving us details as to why you made that choice?
				* Required