Please refer to Q&A before completing this application.
Please Fill in Data Form for Mailing
List and Mail to:
Universal Brotherhood Movement, Inc.
1355 W. Palmetto Park Road, Box 288
Boca Raton, FL 33486
You may pay by credit card by clicking here
(make sure you purchase the Ordination and the Yearly membership)
or you may pay by check by including it with your Application. See Store
for explanation.
(Please
Print Clearly)
LEGAL NAME:
AKA:
NAME AS IT
SHOULD APPEAR ON B. DIV. CERT.:
ADDRESS & ZIP:
PHONE
(H):
(W)
FAX:
EMAIL:
BIRTH
DATE:
COUNTRY OF BIRTH:
NAME OF SPOUSE OR "SIGNIFICANT
OTHER":
PERSON (not living at your address) WHO
WILL ALWAYS KNOW
HOW TO CONTACT YOU:
their address with zip:
their phone: ( )
WHO TOLD YOU ABOUT UB?
MINISTERIAL FOCUS AND NAME:
DO YOU PRESENT WORKSHOPS/SEMINARS? YES
NO
(attach information if yes)
"I Request Ordination into
Universal Brotherhood Movement, Inc."
Signed:__________________________________
(For Minister/Director only)
NOTES AND REMARKS: |
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ATTACH
PHOTO
HERE
CHECK LIST (for office use):
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Universal Brotherhood Movement, Inc.
1355 W. Palmetto Park Road, Box 288
Boca Raton, FL 33486
Voice: (954) 574-9904 Fax: (954) 979-3070
Dr. Rick Prigmore Rick@UniversalBrotherhood.org
Rev. Robin Morini Robin@UniversalBrotherhood.org
©1999-2007 Universal Brotherhood Movement,
Inc
Universal Brotherhood Web Master - Pete Burgess
Webmaster: Pete@UniversalBrotherhood.org
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