Member Profile Information
If any questions, email admin@scottumcindy.org
What’s your family position?
*
Head of Household
Spouse
Child (under 18)
Child (over 18 living in home)
Preferred Title?
Mr.
Ms.
Mrs.
Dr.
Rev. Dr.
Name
First Name
Last Name
Gender
Male
Female
Other
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Can we list your contact information in our directory?
Yes
No
Ethnicity/Race
Please Select
African American
White, Non-Hispanic
Asian
Latino
Hispanic
Other
Marital Status
Please Select
Single
Engaged
Married
Separated
Divorced
Widowed
Profession
Highest Level of Education
Degree(s) Obtained
What are some of your talents and/or giftings?
Child(ren) Name(s), Age(s), and DOB(s)
List any additional relatives that attend SUMC but DO NOT live with you.
Emergency Contact
First Name
Last Name
Emergency Contact's Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact's Email
example@example.com
Joining as…
New Disciple (seeking to be baptized and become a member of SUMC)
Transfer Member (seeking to join SUMC from another Christian church)
Renew Membership Vows (inactive member seeking to recommit themselves to their membership vows)
Already an Active Member
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