ERUCC Directory Form
( All Information submitted on this form will be kept in strict confidence )

(click here for a printable version of this form)


ERUCC Directory Form
2010-2011
 

FAMILY NAME :**
Primary First Name: 
Secondary First Name:   
Children's Names:

  

Address: 

Home Phone: - -
Email:**
   

                I will submit a family picture to the church office. 
                          (Photos may be emailed to aaguilar@erucc.org or send an actual photo to Amy.  We will do our best to
                           return all photos to their owners.  Please label any photos  with your family name on the back. )  
 

                Please have someone contact me to schedule a picture appointment 
  

       I give my consent for ERUCC to publish my information in the directory as indicated above.

      You have my permission to include my email address.

      Please do not publish my email address.

* Required Field(s)
 

 

 

04/30/2011dth