Church Address Request Form

Name of Individual Filling Out Form

First NameLast Name

Email of Individual Filling Out Form

example@example.com

Phone Number of Individual Filling Out Form

Please enter a valid phone number.Format: (000) 000-0000.

Title of Individual Filling Out Form

Below you will fill out information about your church and the adresses associated with it. Please list ALL addresses of locations your church owns, leases, or rents out to other entities. Indicate under each address how this location is used, by whom, and when. You can add up to 10 addresses.

Church Name

Full name please (Ex. First Baptist Church of London, not FBC London)

Current Pastor

First NameLast Name

Current Pastor Email

example@example.com

Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Is your mailing address the same as your physical location for worship?

Physical Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How is this location used?

For what purpose, by whom, and when?

Add an additional address?

Additional Physical Address #1

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How is this additional location used?

For what purpose, by whom, and when?

Add a 2nd additional address?

Additional Physical Address #2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How is this 2nd location used?

For what purpose, by whom, and when?

Add a 3rd additional address?

Additional Physical Address #3

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How is this 3rd location used?

For what purpose, by whom, and when?

Add a 4th additional address?

Additional Physical Address #4

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How is this 4th location used?

For what purpose, by whom, and when?

Add a 5th additional address?

Additional Physical Address #5

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How is this 5th location used?

For what purpose, by whom, and when?

Add a 6th additional address?

Additional Physical Address #6

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How is this 6th location used?

For what purpose, by whom, and when?

Add a 7th additional address?

Additional Physical Address #7

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How is this 7th location used?

For what purpose, by whom, and when?

Add a 8th additional address?

Additional Physical Address #8

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How is this 8th location used?

For what purpose, by whom, and when?

Add a 9th additional address?

Additional Physical Address #9

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How is this 9th location used?

For what purpose, by whom, and when?

Add a 10th additional address?

Additional Physical Address #10

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How is this 10th location used?

For what purpose, by whom, and when?