Full Name *

Registration is required for each person becoming a member.

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Number *

(###)

###

####

Cell Number

(###)

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Work Number

(###)

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Marital Status *

Single

Married

Separated

Divorced

Widowed

Are you a member of UFKBAC? *

Yes

No

Are you affiliated with a church?

Yes

No

Are you consistent in church attendance?

Yes

No

Are you a faithful tithe payer?

Yes

No

Have you been baptized in water? *

Yes

No

Do you have access to a computer? *

Yes

No

Are you a licensed and/or ordained minister?

Yes

No

Do you desire to become a licensed or ordained minister?

Yes

No

Membership Terms and Conditions *

Membership requires an annual fee of $10.00. The Annual Fee will be initially paid on the date of this agreement and then payable annually on each anniversary of the date of this agreement upon receipt. Non-payment of the membership fee revokes all membership benefits.

By clicking submit you agree to the membership terms and conditions.