In order to protect the privacy of the Church, it's Ministers, Board and Members, each member is required to complete the following information stating what personal information they are willing to have published.
You can print this page, fill it out and mail it to the church secretary.
For church use only:
Name:
Phone :
Fill in your information as you would like it to appear in the Member Directory. Leave blank any information you do not want published.
Name :
(i.e. First, middle initial, Last) include title, suffix (Rev., Jr., etc.)
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Home phone
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Work phone
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Cell Phone
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Fax
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Other (specify)
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Address
By signing below, I authorize the Harmonial Philosophy Association to publish the above information in the Member Directory.
Signed: for electronic submission, type full name here
I do NOT want to appear in the Member Directory signed: for electronic submission, type full name here
Fill in your information as you would like it to appear on the Internet Web Site. Leave blank any information you do not want published.
Name (example Rev. J. Doe)
(i.e. First or first initial, middle initial, Last) include title, suffix (Rev., Jr., etc.)
Phone number
By signing below, I authorize the Harmonial Philosophy Association to publish the above information on the Internet Web Site.
Signed: for electronic submission, type full name here
I do NOT want to appear on the Internet Web Site. Signed: for electronic submission, type full name here
Mail to:
Dale Olon-West
PO Box 226
Fredonia, NY 14063-0226
©2009 Harmonial Philosophy Association |
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