_______ I would like to remain on the church membership list at Emmanuel Baptist Church.

_______I am interested in attending Emmanuel Baptist Church again and would like the church to contact me.

_______I am unable to attend services at Emmanuel Baptist Church due to circumstances beyond my control but would like to remain

_______I am attending or have joined another church and wish to be removed from the membership list at Emmanuel Baptist Church.

_______I would like to be removed from the membership list at Emmanuel Baptist Church.