Personal Info
| Church/Organization | |
| Preferred First Name | |
| Street Address | 12908 Apple View Ln |
| City | Burnsville |
| Postal/Zip Code | 55337 |
| Mobile Phone | |
| Website | |
| Home Phone |
General Membership Info
| Membership Credential | |
| Mailing List | Yes |
| Marital Status | Remarried |
| Length of Marriage | 16 years, 10 months ago |