Personal Info
| Church/Organization | |
| Preferred First Name | |
| Street Address | 2082 Wade Dr |
| City | Bogart |
| Postal/Zip Code | 30622 |
| Mobile Phone | |
| Home Phone | |
| Office Phone |
General Membership Info
| Membership Credential | |
| Mailing List | Yes |
| Marital Status | Married |
| Length of Marriage | 23 years, 11 months ago |