BLD Member Survey Form Family Name First Name Middle Name Birthday Gender MaleFemale Wedding Date Civil Status Please SelectSingleMarriedWidowedSeparated Occupation Nickname (optional) Mobile Number Landline Number (optional) Facebook Name (optional) Messenger Name (optional) Email Address Present Address (Street, Barangay, City/Municipality, Province) Complete Name of Spouse (Put 'N/A' if not applicable) BLD Homestead you belong to Los BañosCalambaCabuyaoPilaBayCaluanPutho/Tuntungin BLD Evangelization Program you have attended (write your batch number) ME (Marriage Encounter)FE (Family Encounter)LSS (Life in the Spirit Seminar)SE (Singles Encounter)YE (Youth Encounter)SPE (Solo Parents Encounter)Other ME Marriage Encounter Number FE Family Encounter Number LSS Life in the Spirit Seminar Number SE Singles Encounter Number YE Youth Encounter Number YLSS Youth Life in the Spirit Seminar Number SPE Solo Parents Encounter Number Covenanted? YesNo Covenanted Active? YesNo LSS Shepherd? YesNo LSS Co-Shepherd? YesNo Parish organization member (LCM, MBG, Choir, Ministry, EMHC, Collectors, Others)