BCCM'S MEMBER SURVEY FORM

Enter your name
Enter your e-mail address
Enter your Homepage location, if any
*Enter your postal address*
P. O. Box No.
Street
City
State
Country
Post Code
Please indicate your sex			Male Female
Please indicate your status			Single Married
Please indicate
Kindly indicate the course/s you take, if any
Which BCCM Parish ?
Can we post your email address on the net ?			YES NO
Can we post your prayer items on the net ?			YES NO

PRAYERS REQUEST / SHARING / COMMENTS OR SUGGESTIONS if any

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