UUAMP Membership Application/Renewal Form
Application for membership in UUAMP assumes your agreement with our bylaws, mission and purpose found here:
http://www.uuamp.org/about-us/mission/

Questions? Please Contact:
Corie Jason
UUAMP President
517-351-4081 x 106
cjason@uulansing.org

Last Name: *
Your answer
First Name *
Your answer
Title (optional):
Your answer
Position Title: *
Your answer
Congregation FULL Name (if you are associated with a Congregation): *
If you're not associated with a congregation, answer the following to the best that you're able regarding the organization you are associated with.
Your answer
Congregation/Association Street Address: *
Your answer
Congregation/Association City: *
Your answer
Congregation/Association State: *
Your answer
Congregation/Association Zipcode: *
Your answer
Office Phone Number: *
Your answer
Personal Phone Number: *
Your answer
Email: *
Your answer
Is this a Paid Position? *
Your answer
Hours per Week (paid or unpaid): *
Your answer
Position Start Date:
Your answer
Areas of Responsibility:
General Membership responsibilities already include welcoming and connections.
Skills that you might be willing to share with UUAMP:
Your Region:
if applicable
Your answer
UUA Certified number of members:
if applicable
Your answer
Is this a: *
Required
How did you hear about UUAMP?
Your answer
Full or partial waivers are available to those who find themselves in special circumstances. You can request a full or partial waiver for the current membership year and is good for one year. You may re-apply in a future year. Please enter your reason for requesting the waiver below.
Your answer
Cost of Annual Membership (January - December) is $50.00. Once you submit this form, you will have the option of paying via PayPal with a credit or debit card (with a $1.45 fee added), or via a mailed in check. If you opt to pay with a check, we will send you an invoice within 2 days.
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms