Date:______________________

Name:_________________________________________________________

Address:_______________________________________________________

_______________________________________________________________

City State Zip Code

Telephone No:________________Email:_____________________________

Cell Phone:_______________________________

Family Members:

_______________________________________________________________

_______________________________________________________________

Other Information:

1. Occupations:__________________________________________________

2. Talents & Hobbies:____________________________________________

3. Things you would be willing to do for/at the church. Check off as many as you want.

___host for Abundance Sunday ___read Daily Word Sunday

___help with church maintenance ___ make phone calls

___make visits to the sick, etc. ___fix food for the sick, etc.

___teach an adult class ___teach a children's/youth

___usher at Sunday service class

___serve on Board of Trustees ___participate in weekly healing

prayer circle

4. Other (anything else you would like us to know)

_______________________________________________________________

5.Previous Unity Membership Information:

Location (Address & Phone#)______________________________________

______________________________________________________________________________________________________________________________

6.Unity Awareness Class Completed On:_______________________________

“Wherever we are God is, and all is well.”