CONNECT CLASS
We are excited that you are taking the next step to connection at Eureka UMC! Please complete the following questions to ensure that we have the necessary information to help you find the best place(s) to connect at Eureka UMC.
First name *
Your answer
Last name *
Your answer
Your birthdate *
MM
/
DD
/
YYYY
Spouse's name (if not applicable enter NA) *
Your answer
Spouses birthdate (if applicable)
MM
/
DD
/
YYYY
Do you have children living at home? If so please list each name followed by their complete birth date: mm/dd/yyyy (if you have no children living at home please enter n/a) *
Your answer
E mail address *
Your answer
Spouse's e mail address (if not applicable please enter n/a) *
Your answer
Cell phone number *
Your answer
Spouse's phone number (if not applicable please enter n/a) *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
ZIP Code *
Your answer
Are you new to the Christian faith? *
Have you been baptized? *
Will you be transferring membership from another church? *
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