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November 1, 2004

__________________________ Unitarian Universalist Church

WELCOME and PLEASE PRINT all information:

Date: ___/____/____

Name(s): ________________________________________

Phone: ________________________________________

Email: ________________________________________

Address: ________________________________________

City: ____________________ State: ____ Zip: ________

Children:

Name: _____________________________ Age: ____ School Grade: ____

Name: _____________________________ Age: ____ School Grade: ____

Name: _____________________________ Age: ____ School Grade: ____

Thank you for coming! Please help us and Check all those that apply:

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The Star: ____ Main Saturday Edition

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Other Newspaper ___________________________

Other_______________________________________

Welcome and Thank You for completing this form!

For more information contact interconnections @ uua.org.

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Last updated on Wednesday, September 14, 2011.

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