Membership Interest Form

Membership Interest Form for VUCC

The information that you provide is for our church membership records. A copy is kept in your member folder in the church office, along with the date in which you joined.
Please fill out this form in its entirety.
Please submit one form for each adult.
Children may be listed on either form.

I wish to become a:

Full Member

Associate Member

First Name

Last Name

Spouse/Partner's name:

Marital Status

Wedding Date (optional)

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Please enter your mobile phone.

Phone Number

Email

Please answer the following:

Have you been either baptized or confirmed or both?

yes

no

both

Unsure

Do you currently hold membership at another church?

yes

no

Present or Former Church / Address/Phone:

Present Occupation:

Former Occupation:

Please enter Child(ren) Information or at least one next of kin:

Child or Next of Kin's name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Email address: