Please Update My Membership Record with this Information
Your Name
I wish to make a new annual gift of support
Amount of annual gift?
Period of time for your annual gift
Membership Status
Choose one:
I am a member of United Church
I am a friend of United. Keep me on the mailing list.
I am no longer a member of United. Please Remove me the mailing list.
I would like to join the Church
Email Address
OK to share email address in the members' directory
Home Address
City State Zipcode
OK to share address in the members' directory
Your Birthday
Home Phone
OK to share home phone number in the members' directory
Work Phone
Cell Phone
Best way and time to contact you?
Spouse or Partner
Children at home and their birthdays
Are there any other members of United in your family?
Emergency Contact Person's Name
Emergency Contact Person's Phone Number
SUBMIT FORM
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