Your Donor ID Number: (Can be found on your membership card) Your Name: Check if your name has changed: Other family member's name: Check if this name has changed:
Please complete for street address changes:
Former street or c/o 1:
Former street or c/o 2:
Former City:
Former State, Zip, Country:
New street or c/o 1:
New street or c/o 2:
New City:
New State, Zip, Country:
Please complete for phone/fax/e-mail changes:
Former home phone:
Former business phone:
Former e-mail address:
Former fax:
New home phone:
New business phone:
New e-mail address:
New fax:
Please complete for Congregation/Society affiliation changes:
Former Congregation/Society name:
Former Congregation/Society city & state:
New Congregation/Society name:
New Congregation/Society city & state:
Name & E-mail address of someone to contact if we have questions about these changes (required): Name: E-mail:
If you are already receiving the e-mail bulletin and would like to be removed from our list, please click here.
If you are not a UUSC member, but need to change the e-mail address at which you receive our e-mail bulletin, please click here.
