Personal Info
| Church/Organization | |
| Preferred First Name | |
| Street Address | 812 E Washington Ave |
| City | Ellensburg |
| Postal/Zip Code | 98926 |
| Mobile Phone | |
| Home Phone |
General Membership Info
| Membership Credential | |
| Mailing List | Yes |
| Marital Status | Married |
| Length of Marriage | 10 months, 2 weeks ago |