Wufoo
Cong. Gates of Prayer Emergency Contact Info.
The following information will be inserted into the Temple's emergency database and will only be used to contact you in an emergency.
No other communication will be made using the information below.
PLEASE PRINT CLEARLY
Member's name(s)
Member's cell phone number(s)
Member's personal e-mail address(es)
Please name 2 people (close family members or friends) who are likely to know your whereabouts during an emergency:
Contact 1 Name
Contact 1 Home Phone and Cell Phone
Contact 1 E-mail address
Contact 2 Name
Contact 2 Home Phone and Cell Phone
Contact 2 E-mail Address
Do Not Fill This Out
