Request edit access
UU Community Ministry ID Badge Order Form
Please use this form to order your badge. You will be able to view and approve a proof before your order is finalized. You will receive a plastic ID badge, a UUSCM lanyard, and an attractive leatherlike badge holder. The ID badge has a scannable QR code on the reverse that will enable people to verify that you are member of UUSCM.
What is your salutation and name?
(examples: Joan Johnson, Rev. Joan Johnson)
Are you a clergy or lay community minister?
Are you an active member of UUSCM?
(if you are in doubt, visit
. Only active, paid members are eligible for UUSCM ID badges.)
What is the job or position title you want on your badge?
What is your email address?
This is the address to which we will send the proof of your badge for your approval.
What is your home mailing address?
This is the address to which we will send your finished badge with holder and lanyard.
To complete your order, send a nice digital photo of yourself (SMILING) to
. To pay for your card, make a donation of $28.00 on
, specifying "ID badge," or mail a check to UUSCM c/o Aikman, 8724 Cascadia Ave., Everett WA 98208.
Please enter the date that you are submitting this order:
If you have any questions or special needs, kindly convey them here.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service