Date

Household Last Name

Household Mailing Address

City, St Zip CodeH

Household Phone Number

(###)

###

####

Listed?

Member Name (First, Middle, Last)

Birthdate

Baptism Date

Confirmation Date

E-mail

Cell Phone

(###)

###

####

Text?

Spouse Name (if applicable) (First, Middle, Last)

Birthdate

Baptism Date

Confirmation Date

Cell Phone 2

(###)

###

####

Text 2?

Family Information -- Marriage Date

Names of children becoming members with you. Please include Full Name, Birthdate, Grade, Baptism Date and Confirmation Date. Please list any information that may be helpful to the staff at ULC concerning special circumstances involved with the children: ie: step-children; different address than yous, etc.

Spiritual Information -- Are you presnetly a member of a church:

If yes, name and address of your former church

What brought you to ULC?

Do you know anyone already in the congregation? If so, who?

Would you like to know more about any of the following for your family?

Baptism

Sunday School

Confirmation

Bible Study

Bibles (typically given in Pre-K & 5th Grade)

First Communion Instruction (typically done at 5th Grade)

Communication Information -- How would you like to receive "The Covenant," the ULC Monthly Newsletter?

Preferred E-mail