Personal Info
| Church/Organization | |
| Preferred First Name | |
| Street Address | 6389 E Viking Blvd |
| City | Wyoming |
| Postal/Zip Code | 55092 |
| Mobile Phone | |
| Website | |
| Home Phone |
General Membership Info
| Membership Credential | |
| Mailing List | Yes |
| Marital Status | Married |
| Length of Marriage | 4 years, 5 months ago |