ESUUC Directory Submission – East Shore Unitarian Universalist Church

Include all first AND last names of household who are members *

Children first name(s) if desired

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email address #1 (include name of person it belongs to!) *

Email address #2 (include name of person it belongs to!)

Home phone # *

If not in use, please enter "None"

Mobile phone #1 (include name of person it belongs to!) *

If no mobile phone, please enter "None"

Mobile phone #2 (include name of person it belongs to!)

If no mobile phone, please enter "None"

Member or friend? *