New Member We’re so glad you’re here! Thank you for helping us gather your basic info so that we can keep you connected with our PTCUMC community! Person 1(Required) First Middle Last Preferred Name Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Person 1 Email(Required) Person 1 Cell Phone(Required)Other PhonePerson 1 Birthdate(Required) MM slash DD slash YYYY Person 1 | Former Church(Required) Please state if there is no previous membership.Person 1 | Have you been baptized?(Required) Yes No Person 1 | Former Church Address Street Address City State / Province / Region ZIP / Postal Code Person 2 Name First Middle Last Preferred Name Person 2 | Address Same as Person 1 Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Person 2 | Email Person 2 | Cell PhonePerson 2 | Other PhonePerson 2 | Birthdate MM slash DD slash YYYY Person 2 | Former Church(Required) Please state if there is no previous membership.Person 2 | Have you been baptized?(Required) Yes No Person 2 | Former Church Address Same as previous Street Address City State / Province / Region ZIP / Postal Code ChildrenFirst NameMiddle NameLast NamePreferred Name:M/FBirthdateGradeBaptized (Y or N)Date BaptizedConfirmed (Y or N) Add RemovePhoto Consent Permission to use photos of me/my family for marketing & promotion.Please Upload a Recent Family PhotoMax. file size: 50 MB.If possible, we’d love the photo to be horizontal. Thank you! Δ
