Please fill out the following form for our online directory. Only enter information that you want to appear in the directory. We are very excited to create this directory for our church and look forward to your submission. Thank you!

Family Last Name

Adult 1 Name

First Name

Last Name

Adult 1 Cell Phone

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Adult 1 Email

Adult 2 Name

First Name

Last Name

Adult 2 Cell Phone

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Adult 2 Email

Child 1 Name

First Name

Last Name

Child 1 Cell Phone

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Child 1 Email

Child 2 Name

First Name

Last Name

Child 2 Cell Phone

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Child 2 Email

Child 3 Name

First Name

Last Name

Child 3 Cell Phone

(###)

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Child 3 Email

Child 4 Name

First Name

Last Name

Child 4 Cell Phone

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Child 4 Email

Child 5 Name

First Name

Last Name

Child 5 Cell Phone

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Child 5 Email

Child 6 Name

First Name

Last Name

Child 6 Cell Phone

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Child 6 Email

Family Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

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The information you give will be posted in our online VUMC photo directory. Only those with email addresses in the directory will be able to access it. The information may be used to send news out for upcoming VUMC events. By clicking this box, you are acknowledging that you understand and agree to these statements. If you do not agree, you will not be included in the directory. Thank you!

I agree.