Online Visitor Form

Unitarian Universalist Church in Eugene Visitor Information

Please use this form to provide UUCE with your contact information, to request a contact from our ministerial staff, and to indicate you would like to sign up for our newsletter email list.

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* 1. Name (Full, First and Last)

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* 2. Preferred Name:

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* 3. Pronouns

She/Her

He/His

They/Them

Ze/Zir

Other (please specify)

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* 4. Best way to contact:

Call

Text

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* 5. Contact Information:

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 6. I would like a call from the Ministerial Staff

Yes

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* 7. I would like to sign up for the UUCE email list, and receive the Weekly Connections newsletter.

Yes

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* 8. Is this your first time coming to a UUCE Service?

Yes, this is my first time ever at a UUCE Service (in person or online)

This is my first time attending an online service at UUCE (I have attended in person)

This is my second time at a UUCE Online Service

This is my third time, or more at a UUCE Online Service

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* 9. Do you have children in your household?

My household has children aged 0-5

My household has children aged 5-12

My household has Middle School aged youth

My household has High School aged youth