Directory Information Form

Directory Information Form

Please enter your information for the church directory. There are three required fields: 1) pick yes or no to be included (or not) in the directory, 2) "Entry Name" - the name under which you want you or your family listed, and 3) "Member/Friend #1 First name" - the first name of one of the adults associated with the entry name. However: if you want people to be able to use the directory to contact you, you should enter more information! A sample entry with all fields entered is shown below for Jen and Charlie Thomas' family, including a photo (the only one that Charlie could find of the 5 of us. It is likely we will NOT use this particular one). When you have finished, please click the "Submit" button way down at the bottom of the form (scroll down and you will see it)

Once complete, printed copies of the directory can be provided upon request and it will be posted in a password-protected page on this website. Details of how to request a printed copy and how to access the password-protected page will be provided once the directory is complete.

Questions? Please contact Charlie Thomas (Directory Coordinator) at ucclcmemberdirectory@gmail.com

Permission

Please choose yes or no *

Yes, I do want my contact information included in the directory No, I do not want my contact information included in the directory

Information Entry

* Indicates required field

Entry Name - this is the name under which your entry or your family's entry will appear in the directory, it should be a LAST name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Family Email Address *

Member/Friend #1 First name *

Member/Friend #1 Last Name, if different from directory entry name *

Member/Friend #1 Mobile Phone Number *

Member/Friend #1 email address *

Member/Friend #2 First name *

Member/Friend #2 Last Name, if different from directory entry name *

Member/Friend #2 Mobile Phone Number" *

Member/Friend #2 Email Address *

Below, please enter the names and birth dates of any children associated with this entry. Please separate the name and birthdate by a comma. If your entry includes more than 6 children, please enter their names in the text box following the "Child 6 First name" Separated by a comma.

Child 1 First Name, Birthdate MM/DD/YYYY *

Child 2 First Name, Birthdate MM/DD/YYYY *

Child 3 First Name, Birthdate MM/DD/YYYY *

Child 4 First Name, Birthdate MM/DD/YYYY *

Child 5 First name, Birthdate MM/DD/YYYY *

Child 6 First Name, Birthdate MM/DD/YYYY *

For families with more than 6 children, please enter their names separated by comma *

Submit