Reproducible Pages / 109

Star Information
K
n
Name
Nickname

Address Attach photo

o
of girl here
City State Zip Code

w
Phone number
Birthdate
Hobbies/Interests
Other information

Has she asked Jesus into her heart?

Units completed/Date of completion:

Yes No
Y
1
2
3
8
9
10
15
16
17
22
23
24
o
4
5
6
11
12
13
18
19
20
25
26
27
u
7 14

Parent Information
21

r
Father’s Name Marital Status:

S
Address Single
Married
Divorced
City State Zip Code Separated

t
Widowed
Phone number E-mail
List names and ages of
Mother’s Name
brothers and sisters:

a
Address

City State Zip Code

r
Phone number E-mail
Note: If this child moves to another church, please copy and send this form with them. Keep a copy for your files.

© 2009 by Gospel Publishing House, 1445 N. Boonville Ave., Springfield, Missouri 65802. All rights reserved. Permission to duplicate for local church use only.
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