Membership Registration Form - UNITED CHURCH OF CHRIST AT THE VILLAGES

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Membership registration form

* Indicates required field

Name (member 1) *

First

Last

Birthdate (month/day/year) *

Occupation *

Personal Pronoun Preference *

Choose Occupation status *

Current Retired

Cell Phone Number *

I would like my cell phone number printed in the online directory *

Yes No

Email *

Name (member 2) *

First

Last

Birth date (month/day/year) *

Occupation *

Choose Occupation Status *

Current Retired

Cell Phone Number *

I would like my cell phone printed in the online directory *

Yes No

Email *

Home Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

If you live in The Villages, please state the Village you are in *

Secondary Address *

Line 1

Line 2

City

State

Zip Code

Country

If seasonal, what months do you live in Florida? *

Marital Status *

Single Married Partnered Divorced Widowed

Wedding Anniversary Date (day/month/year) *

If applicable, please list names & ages of children *

Emergency Contact Name *

First

Last

Relationship to you *

Address of Emergency Contact *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

How Would You Like to Join UCC at The Villages? *

Full Member Associate Member (allows you to maintain full membership elsewhere) Transfer Letter (you are transferring from another church) Reaffirmation of Faith (was a member elsewhere but attended/participated rarely) Profession of Faith (non-member or inactive member of a church) Online Member only

Date you wish to join (day/month/year) *

Full Name of Member 1 (as you would like it on your name tag) *

First

Last

Member 1: Would you like your name tag magnetic or pinned? *

Magnetic Pinned (Pacemaker friendly)

Full Name of member 2 (as you would like it on your name tag) *

First

Last

[object Object]

Member 2: Would you like your name tag magnetic or pinned? *

Magnetic Pinned (Pacemaker friendly)

Submit

DONATE TO UCC IN ANY OF THE FOLLOWING WAYS:

CLICK ON THIS LINK TO SET UP GIVING THROUGH OUR SAFE & SECURE ONLINE APPLICATION
MAIL A CHECK TO: UCC AT THE VILLAGES, PO BOX 194, OXFORD FL 34484
SET UP DONATIONS THROUGH YOUR OWN BANK OR CREDIT UNION

CLICK ON THIS LINK TO SEE ALL THE VOLUNTEER OPPORTUNITIES AVAILABLE - THERE IS SOMETHING FOR EVERY SKILL AND INTEREST!

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Copyright © 2015

Home
About Us/Information
GIVE
Worship Services
Church Calendar
- Calendar of Events
- Upcoming Special Events
Volunteer
Ministries & Groups
- Ministries
- Small Groups
Prayer Requests
Newsletter
Photos
- More Photos
The Gardens
Disaster Planning
Hearing Loop
Member Directory
Pastoral Care Team
Videos