MEMBERSHIP RECORD UPDATES

Please fill out the following form. Please check the option below most appropriate for your situation. If you have not responded by November 10, 2025, we will conclude that it is your desire to be removed from membership at Shiloh Church.

Member First/Last Name

Please check one option below:

I/we desire to remain a member of Shiloh Church. Please contact me using the information I provide.

I/we have found another church home and would like to be removed from the Shiloh membership

If you answered yes, to the above question, please provide your current church

I/we desire to be removed from Shiloh’s membership.

Phone

Signature(s)

This e-signature represents your consent for Shiloh to use the information provided in this form to update our records