UUFR Membership Form

Name

Pronouns

Pronouns on Name Tag

Print my pronouns on my name tag. Do not print my pronouns on my name tag.

This address will receive a confirmation email

Mobile Phone

Home Phone

Address

Date of Birth

Family Information

If you and a spouse or partner are joining at the same time, each of you should complete this form.

Name of Spouse/Partner

Spouse or Partner's Pronouns

Is your spouse or partner already a member of this congregation? joining at this time?

Names and birthdates of any minor children

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone Number

Financial Contribution

UUFR depends on the financial generosity of its members to fulfill its mission. Every member is asked to make a pledge to the congregation each fiscal year. Our fiscal year begins in July and ends in June. Members are asked to make a pledge based on a percentage of their incomes. For more guidance about how much to give, visit www.uufr.org/moneymatters .

There are many ways to fulfill one’s financial pledge - - by mailing a check to the UUFR office, by setting up automatic payments through your own financial institution, by setting up regular online payments through our website, or by downloading the GivePlus app for your smartphone.

An exemption from pledging is available to any individual or family experiencing extreme financial difficulty.

My monthly pledge until June, 2025 is...

I plan to pay this pledge

monthly quarterly yearly

This pledge is on behalf of

myself my household

Please write a short self-introduction that will be available to other UUFR members.

Bio

Education & Work

This information is only available to staff and specific lay leaders

School

Job Title

Employer

Demographic Information

This information may allow us to let you know about special programs or events at UUFR or within the wider Unitarian Universalist community. This information is only available to staff and specific lay leaders.

Do you self identify as any of the following? BIPOC (Black, Indigenous, Person of Color) LGBT

Medical Information

This information is available only to UUFR staff.

Allergies

Accessibility Issues

Other Relevant Medical Information

Privacy Opt-Out Options

Membership Announcement

It's okay to announce my name as a new member in The Chalice and during a Sunday worship service. I'd prefer my name not be mentioned in The Chalice or during a Sunday worship service.

I do not want my name or picture included in a directory that will only be available to UUFR members. (To customize which phone numbers, emails, or U.S. mailing addresses you want to make private to staff or make available to other UUFR members, edit the Contact section in Breeze. You will receive an invitation to create a login for the membership directly shortly after filling out this form.) Check here to opt-out

I do not want my name or any image of me used in publicity, including in the newsletter, on the UUFR website, or on UUFR-sponsored social media. Check here to opt-out

Please list my child/children’s names in a directory available to UUFR members. Yes No

Photo

We would like to include a photo of you and, if applicable, your family, in our directory. If you would like to have additional photos of family members included, please email them to annie@uufr.org.

Photo of you/your family for UUFR Member Directory

Upload (8MB)

Is there anything else?

Is there anything else that is important for UUFR staff or lay leadership to know about you at this time?

Today's Date

UUFR Membership Form

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