Full Name (First Middle and Last) (required)
Date you would like to join SMUMC (required)
Date of Birth (required)
Date of Baptism Place of Baptism
Date of Confirmation Place of Confirmation
Spouse's Full Name (First, Middle, Maiden and Last)
Spouse's Date of Birth
Spouse's Date of Baptism Spouse's Place of Baptism
Spouse's Date of Confirmation Spouse's Place of Confirmation
If Married -- Anniversary Date:
Current Address (required)
Telephone Numbers:
Spouse's Telephone Numbers:
Email Address(s): (at least one email address is required for receipt)
Church Transferring from:
Please List ALL Other Family Members Joining SMUMC (Including Name/DOB/Date and Place of Baptism/Date and Place of Confirmation)
Would you like to receive our weekly blast? noyes Email you would like the eBlast sent:
May we publish your address in our church member directory? noyes
Notes:
