Next-Of-Kin Form - Webster Groves Presbyterian Church
ADVERTISEMENT
1
2NEXT-OF-KIN FORM
Webster Groves Presbyterian Church
There are occasions in the care and concern for one another when it is desirable for the church to have
on record the names of next of kin and/or close friends. We would appreciate your sharing this
information, as well as keeping it up to date when any of the information changes. This form will be
kept in a confidential file and will be used ONLY in the case of an emergency.
Date: ______________________
Name ______________________________________
Address _____________________________________
City _______________________________
State ______ Zip ____________________
Phone (______)______________________
Cell (______)________________________
Name of spouse or other family member living with you _________________________________________
Your alternative address _______________________________
City _______________________________
(if applicable)
Your alternative phone number (______)_________________
State ______ Zip _____________________
People to Contact in Case of Emergency
Your next of kin—such as a son, daughter, sister, etc.:
Name_____________________________
Relationship ________________________
Address ___________________________
City _______________________________
Phone (______)_____________________
State ______ Zip ____________________
A second person (if you choose):
Name_____________________________
Relationship ________________________
Address ___________________________
City _______________________________
Phone (______)____________
State ______ Zip ____________________
Someone who might know about your schedule or travels, if there is a need or a concern, and we need
to contact you:
Name_____________________________
Relationship ________________________
Address ___________________________
City _______________________________
Phone (______)_____________________
State ______ Zip ____________________
Please return to our church office:
Webster Groves Presbyterian Church
ATTN: Dr. Lancaster
45 West Lockwood Avenue
St. Louis, MO 63119
K:\Blythe\Congregational Care\NOK Form\Next of Kin Form.docx
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business