New Member Information

SECTION ONE: Information about YOU.

Name

Pronouns

Gender

Date of Birth

Employer

Your Contact Information and Preferences

This address will receive a confirmation email

Subscribe to e-mail list?

Phone

By selecting "Yes" below, I am consenting to receive SMS messages from Breeze regarding information and announcements for First Congregational UCC. I understand that message and data rates may apply and message frequency varies. I can opt out by responding STOP at any time. For support I can text HELP to 87447. Please review the Breeze Privacy Policy and Terms of Service available at breezechms.com for more details.

I consent to receiving announcements via SMS (text messages)

Yes No

Address

Your Emergency & Health Info

Note: the information in this section is available to church staff and key leaders to assist in emergency situations or making accommodations. It is not published in the directory, etc.

Your legal name is helpful if we ever need to visit you in the hospital.

Legal name, if different

Emergency contact information (name, phone, relationship)

Dietary restrictions

Requested accommodations or health information you'd like to share with us.

SECTION TWO: Information about other family members in your household

Please skip this section if not applicable

Adult #2 Name

Adult #2 Pronouns

Adult #2 Gender

Adult #2 Date of Birth

Adult #2 Employer

Wedding anniversary, if any

Adult #2 Contact Information and Preferences

Note: if the information for your spouse/partner is the same as yours (i.e. address), you can just write "same" in the field below.

Adult #2 Email

Adult #2 Subscribe to e-mail list?

Adult #2 Phone

Adult #2 Address

Adult #2 Emergency and Health Info

Note: the information in this section is available to church staff and key leaders to assist in emergency situations or making accommodations. It is not published in the directory, etc.

Adult #2 Legal name, if different

Adult #2 Emergency contact information (name, phone, relationship)

Adult #2 Dietary restrictions

Adult #2 Requested accommodations or health information you'd like to share with us.

SECTION THREE: Information about any children in your household

Please share the following information:
First and last name
Date of birth
Gender
Pronouns

Please share information about children here:

SECTION FOUR: Membership Information

If any of the adults in your family are NOT becoming members, please specify here:

I/we are joining by

If joining by Letter of Transfer, please share contact information for your former congregation so we can contact them.

SECTION FIVE: Other Household Information

Note: the only information displayed in the church directory is name, pronouns, phone, email, address, a list of your family members, and your photo.

If you select "yes" but do not want your phone, email, or address listed in the directory, please contact the church office and we can mark one or more as unlisted.

List in directory?

Family photo or your photo (for directory)

Upload (8MB)

Does anyone in your family need name tags? If so, please list how you'd like your names on the tags here:

Are there ways in which First Congregational UCC can be supportive of you at this moment in time?

Are there things you enjoy doing or would like to participate in at First Congregational?

We would love to introduce you to the rest of the congregation via our monthly church newsletter. Please write a couple of paragraphs about you/your family. You might want to include information about your profession, hobbies, passions; your religious background; what brought you to First Congregational; why you decided to become a member of our congregation. The newsletter is mailed to members/friends of First Congregational. We will not publish your bio or photo in the "website version" that is accessible to the public.

My/our bio for the newsletter

New Member Information

Description

Please Fix the Following