Minister Information Change Form

What information are you wishing to update today? Please select all that apply.*

Former Name*

New Name*

Briefly tell us why your name has changed. *

This is a change to my ...*

physical addressmailing addressboth physical/mailing

New Address*

ADDRESS LINE 1

ADDRESS LINE 2

CITYSTATE

POSTAL/ZIP CODE

New Phone Number*

Please enter a valid phone number.

New Phone Kind*

MobileWorkHomeOther

Is this the primary number we should contact you at?*

YesNo

Primary Phone Number*

Please enter a valid phone number.

Primary Phone Kind*

MobileWorkHomeOther

New Email*

example@example.com

Current Marital Status*

MarriedDivorcedWidowedRemarried

Spouse's Name*

FIRST NAMELAST NAME

Anniversary*

Date

Please share any pertinent details we should know about your divorce.*

We are so sorry for your loss. Please share with us the name of your deceased spouse and the date he/she passed.*

Former Congregational Affiliation*

Former Congregation Location*

CITY, STATE

New Congregational Affiliation*

New Congregation Location*

CITY, STATE

Please briefly tell us the reason for this congregational affiliation change, including the date it goes into effect.*

Please share any other updates you have for us in the box below.

Information Update