This information card will be sent to the membership team.  Your information will not be shared outside of UUCT.

Name *

First

Last

Email *

Address

City

Zip Code

Phone

Emergency Contact (name, phone)

How May We Serve You?

• I/We would like to be on the email list
• I/We are interested in joining the church
• I/We would like to talk about UUCT

How Did You Find Us?

• Friend/relative
• Drive by sign
• Web site
• Facebook
• Other

Have you visited our church before?

• Yes
• No

Have you attended a UU church before?

• Yes
• No

Your age range:

• 16-19
• 20-35
• 36-49
• 50-64
• 65+

Are you a Snowbird?

• Yes
• No

Pertinent Additional Information

Submit