Former Church Information
Initially we will be sending your former church home a request for confirmation of your status. Once you become a Colonial member, we will notify them of your change in membership.
Even if you do not have a former church home, please fill in your name and put NONE in the Church Last Attended box.
Couples, if your membership is with the same church complete a single form. If you and your spouse have different memberships, please complete separate forms.
Needed only if your membership is under your maiden name
Church Last Attended
Email Address of Church
Please include a complete mailing address
City, State and Zip Code
I am/We are a member(s) of this church
Alternate church name and address
If you are a member(s) of a church other than the last one you attended, please include that information (name & mailing address) here:
I release Colonial to receive any information related to my relationship with the church(es) listed on this form
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