Change of directory information form for Unitarian Universalist Fellowship of Topeka
(please enter only information that has changed from the listing as contained in the directory)

Please enter your name (required):


Please enter your e-mail address (required):


Please enter your U.S. Postal Service street address or P.O. Box:


Please enter your City, State & Zip Code:


Please enter your area code & home telephone number:


Please enter your area code & work telephone number:


Are you a member? (Yes or No and date membership book signed, if known):


Would you like to receive a visitor's packet, if you haven't already? : No Yes

Would you like to receive a membership packet, if you became a member after January 1, 1999? : No Yes

Please enter any comments or questions: