Shepherd of the Hills Lutheran Church Shoreview MN Minnesota

Shepherd of the Hills Church

Change of Information

Do you have a change of address? Phone Number? Name? Marital Status? Do you have a temporary / vacation address? New birth or adoption? Please complete this form and submit to the church office.

Today's Date:
Effective Date?
Change What?	Address
	Phone Number
	Marital Status
	Name
	Other (fill in below)
Specify 'Other' Change:
Name(s):
Birth or Adoption (full name and date)
Prior Marital Status:	Married
	Widowed
	Divorced
	Single
New Marital Status:	Married
	Widowed
	Divorced
	Single
Old Address
New Address:
Temporary Address?	Yes
Temporary Address?	No
If 'yes' above, specific dates
Old Telephone:
New Telephone:
Temporary Phone?	Yes
Temporary Phone?	No
If 'yes' above, specify dates:
Old Email Address:
New Email Address:
Additional Information & Comments:

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Shepherd of the Hills Lutheran Church - 3920 North Victoria Street
Shoreview, Minnesota 55126
Phone (651) 483-5419 - Fax (651) 483-2296
Send Email to Shepherd Secretary

Click HERE for Shepherd Staff contact information.