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Please fill out the online Community Database Update form (below) to

  • register your contact information with the Community;
  • update your name, address, phone number, or email address; OR
  • update your service availability, and/or past service information.

Maintaining accurate email addresses is necessary to be able to communicate news of interest to the Community in a timely and affordable manner. Also, when assembling teams for upcoming Walks or Flights, we rely upon our Community Database for the phone numbers to contact prospective team members.

Any information you provide will only be used for Community purposes.  THANK YOU!

Quad Cities Emmaus Community Database Update

Please fill in the following information to update your entry in our database. Please complete as thoroughly as possible even if only some of your information has changed.

TO SUBMIT YOUR CHANGES, click on the 'Send update!' button at the bottom of the form. THANK YOU!
Name *  
First *
Last *
Street Address
Zip Code
Phone 1

Phone 2

Email Address
Walk or Flight #

Service Interest/Availability

Please let us know how you would like to be of service to the Community.
Serving on a Team
 Yes, I am interested 
 No, not at this time 
I Can Be a Musician
 serve on team as a musician 
 play guitar 
 play piano 
 sing lead vocals 
 sing backup vocals 
 play other instrument 
Check all of the above that apply.
List other instruments played.
I Can Be a Tech Person
 serve on team as a tech person 
 help create visuals for weekend 
 willing to learn how to create and run visuals 
Check all of the above that apply.

Past Walk Service

Indicate the Walk leadership positions you have held, and the talks you have given.
Past Walk Roles
 Weekend Lay Director 
 Assistant Weekend Lay Director 
 Board Representative 
 Tech Person 
 Agape Chapel Leader 
 Agape Chapel 
 Table Leader 
Check all of the above that apply.
Laity Talks Given
 Priesthood of All Believers 
 Life of Piety 
 Grow Through Study 
 Christian Action 
 Changing Our World 
 Body of Christ 
 Fourth Day 
Check all of the above that apply.
Clergy Talks Given
 Prevenient Grace 
 Justifying Grace 
 Means of Grace 
 Obstacles to Grace 
 Sanctifying Grace 
Check all of the above that apply.
Please indicate your current license or ordination status.
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