Update Your Info

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Update Your Membership Records

Is your membership information correct and up to date? Have you recently moved, changed your phone number, changed jobs or opened a new email account? If so, please help us out by completing the following information form. By doing so, you can help us keep you informed of all the news and events happening around Western Avenue and also help us save postage and printing dollars by eliminating incorrect information.

Please submit only the information that is new to the church or that has changed recently.

This information will never be shared, sold or given to any other party. It will remain in Western Avenue's database until your membership changes or you request that it be deleted. The information given is used only for contact and record-keeping purposes.

Head of Household Information

Full Name

Preferred Name

Address 1

Address 2

City

State

Zip

Phone Numbers

Primary Home:

Primary Work:

Primary Cell:

Date of Birth

Month Day Year

Marital Status

Single Married
Widow/Widower Separated/Divorce

Member Status

Member Prospective Member Long-time Guest/Not a Member

Spouse Information (if applicable)

Full Name

Preferred Name

Phone Numbers

Primary Work:

Primary Cell:

Email (if different)

Date of Birth

Month Day Year

Member Status

Member Prospective Member Long-time Guest/Not a Member

Children's Information (if applicable)

Full Name

DOB

Full Name

DOB

Full Name

DOB

Full Name

DOB

Full Name

DOB

Other Information

Western Avenue Baptist Church | 1206 Museum Road | Statesville, NC 28625 (p) 704.872.4139