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PARISHIONER CONTACT FORM
Persons name
*
First name
Last name
Persons address
*
Address line 1
Address line 2
Address line 3
Address line 4
Town/Suburb
City
Postcode/Zip
Show on directory ?
Ethnicity
*
American
Assyrian
Australian
Chinese
Chinese Malaysian
Columbian
Dutch
English
Eur
European
Fijian
Filipino
Filipino/Pakeha
German
Hong Kong chinese
Hungarian
Indian
Indonesian
Iraqi
Iraqui
Irish
Italian
Jordanian
Kirabati
Korean
Malaysian
Malaysian/Chinese
Maori
NZ European
NZ European/Maori
Pakeha
Pakeha/American
Pakeha/Chinese
Pakeha/Cook Is
pakeha/english
Pakeha/Filipino
Pakeha/Irish
Pakeha/Malaysian
pakeha/phillipino
Pakeha/Samoan
Phillipino
Polish
Portugese
Samoan
Samoan/American
scottish
Singaporian
South African - European
Spanish
Sri Lankan
Swiss
Tongan
unknown
Vietnamese
Welsh
Date of Birth
*
Cell phone
Show on directory ?
Email address
*
Preferred contact method
*
Email
Text
Letter
Phone
Facebook
Slack
Cell
Relation to House
*
Adult
Adult child
Child
Flatmate
Grandparent
Guardian
Lodger
Single
Sister
Spouse
I would like information on the Planned Giving Programme
*
Please tick yes for information to be emailed to you
Please check the highlighted fields
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