| Church/Organization | |
| Preferred First Name | |
| Street Address | 3980 Walden Shores Rd |
| City | Wayzata |
| Postal/Zip Code | 55391 |
| Mobile Phone | |
| Home Phone |
| Membership Credential | |
| Mailing List | Yes |
| Marital Status | Married |
| Length of Marriage | 34 years, 6 months ago |
