Mid-Year Contact Update – Northern California Nevada Conference

New Mailing Address*
Street Address Address Line 2 City State ZIP Code
New Email Address*
New Phone Number*
Phone Number Type*
- Mobile Phone
- Home Phone
Position Title*
Is New Employer/Ministry Setting:*
- An NCNC-UCC Local Church
- A Local Church NOT Affiliated with NCNC-UCC
- Another Type of Employer/Ministry Setting
Name of NCNC-UCC Local Church*
Name of New Employer/Ministry Setting*
Address of New Employer/Ministry Setting*
Street Address Address Line 2 City State ZIP Code
Affiliation of Church*
Have you updated your Ecclesial Covenant?*
- Yes - New Covenant With Association Established
- In Process with Association
- No - No Covenant Required (Non-Ecclesial Employment)
- No