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Your Address Your City (required) Your State (required) Your Zip Code Your Phone Age(s):College20s30s40s50s60s-plus Children at Home (names/ages): Please check any of the following: Traveling through this areaCame with relatives/friendsI will be moving to this areaI just moved to this areaLooking for a church homeI want to know more about UCCI would like to place membershipI am visiting and am a member at: Prayer Requests: Please check all that apply: Public Prayer - to be shared with the church family at a future timeConfidential for elders and ministers onlyConfidential: would like an elder or minister to call (phone number listed above)×
Your City (required) Your State (required) Your Zip Code Your Phone Age(s):College20s30s40s50s60s-plus Children at Home (names/ages): Please check any of the following: Traveling through this areaCame with relatives/friendsI will be moving to this areaI just moved to this areaLooking for a church homeI want to know more about UCCI would like to place membershipI am visiting and am a member at: Prayer Requests: Please check all that apply: Public Prayer - to be shared with the church family at a future timeConfidential for elders and ministers onlyConfidential: would like an elder or minister to call (phone number listed above)×
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Age(s):College20s30s40s50s60s-plus
Children at Home (names/ages):
Please check any of the following: Traveling through this areaCame with relatives/friendsI will be moving to this areaI just moved to this areaLooking for a church homeI want to know more about UCCI would like to place membership
I am visiting and am a member at:
Prayer Requests:
Please check all that apply: Public Prayer - to be shared with the church family at a future timeConfidential for elders and ministers onlyConfidential: would like an elder or minister to call (phone number listed above)
