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	Get UPDATED: Members can login here to update your contact information. We are continually updating our database, so please remember to let us know if your address, phone number or email changes. Remember, we don't know if you don't tell us! Please email us with your changes or drop the info in the offering.

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Community Group Placement Form

Belmont has community groups meeting across Middle Tennessee. We encourage every member of Belmont to get involved in a weekly cell group for spiritual growth and accountability. If you would like us to to help you find a community group, please fill out this form and submit it to our office.

Mr./Mrs./Ms.:		Date:
First Name:		Last Name:
Address:		City:
State:		Zip:
Email:		Home Phone:
*Member: Visitor:*
Address/Email Change: Attend Regularly: Out of Town Guest:
Married: Single: Single Parent: *Widow:*
*Age Group:*	18 - 23 24 - 35 36 - 59 60 - Up
*His Work Phone:*		*Her Work Phone:*
*His email:*		*Her email:*
*Children/ages:*
*School Grade(s):*	PS K 1 2 3 4 5 6 7 8 9 10 11 12 College

Please check boxes that apply

I would like to know more about Belmont:

I would like for a Pastor to get in touch with me: Daytime Evening

I would like information about joining a Belmont cell/family group:

I would like information about becoming a member at Belmont:

Comment/Preferences:

Prayer Request/Praise Report

If you have a prayer request or praise report you would like to share with us, please note below.

Name: Date: