Member Information Form

Please use the electronic form below to include your information in our database or update your information.

Another option is to download the Member Information Form to fill out and mail.

Our membership is supported by your donations.  Please consider supporting us in this way.

Printed Membership Forms can be sent to :

Debra Kigar

304-945 Daryl Drive, Burlington ON L7T 0A1

 

 

    Date (Required):
    Email (required)

    First Name (required)
    Last Name (required)

    Other Email
     

    Street/Apt/Box
    Community
    Province

    Postal Code
    Country

    Landline
    Cell

    Denomination
    If the UCC, which region?

    Diaconal Workplace if applicable
    Identification, are you
    If Other, please describe

    If this is a recent identification for you, please give details (for example date and place of commissioning
    or retirement, etc.)
    Which category best describes your current diaconal ministry (pick as many as apply)
    congregationalinstitutionaleducationalsocial justicepastoral careadministrativetent makingretiredfull timepart timevolunteerstudentother
    Please elaborate if useful
    This membership submission will be for
    NewRenewalFor Membership Year
    Membership Fees are a tangible way to support the work of the our association, it’s executive, and it’s committees. The amount of your support is flexible as you may offer what you can afford. The suggested annual membership fee is $130.00. The minimum annual fee is $15. If you are able, you are encouraged to pay an annual fee of $155.00, which helps to offset those paying a lower amount. All membership fees are tax deductible as donations.

    For pre-authorized withdrawal from your bank account
    Download PAR Form and send it along with a VOIDED cheque to
    DUCC Treasurer, (address above)
    For Annual Payment
    Make cheque payable to Diakonia of the United Church of Canada, and send to the Treasurer.

    You can also pay by e-transfer to [email protected]

    Amount
    Payment Method

    Church Representation: If you are on a committee in your region or a General Council Committee or Task Group that has responsibility in some way for diaconal ministry, or as a diaconal rep, please describe.
    Growing our website
    Do you have a thesis that is not already on the website? (see Scholarly Works.) If it is available electronically please attach here. (PDF format is preferred, but doc or docx is acceptable)

    If the thesis is unavailable electronically please detail the Title, degree, school, year and 2 sentence description.
    Profile: Have you created your Profile, or have you checked to see that it is up to date?

    Thanks for doing that!
    If you still have not created your profile, please create your profile now!
    Optional: Attach a recent GOOD QUALITY photo that we can attached to your profile.
    Comments


    The information is sent by email to the Treasurer and to your e-mail address. Our system is not without its glitches sometimes. IF you receive an error message asking you to contact the administrator, please do not resubmit. E-mail [email protected] and let us know! Thanks.

    Membership in DUCC is open to anyone affiliated in some way with the United Church who understands themselves to be in diaconal ministry.  You’re involvement is welcomed!