Individual Directory Form

Use this form to add your listing to our directory, changes and/or membership statistics.

Unique ID
Consent*
This directory is intended solely for information purposes. The information provided is for updating your contact information in the Presbyterian Church (U.S.A.)’s Racial Equity & Women Intercultural Ministries congregation and individual directories. We do not sell or trade our information with any other organization. By providing your contact information you give the Presbyterian Church (U.S.A.) permission to use your personal information in our directory.
- I agree
I am:*
Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Home Phone*
Cell/Mobile
Email
Enter Email Confirm Email
Presbytery*
Synod*
My role*
- Minister of Word and Sacrament
- Ruling Elder
- Deacon
- Commissioned Ruling Elder
- Specialized Ministry
- Other
Date of Ordainment
MM slash DD slash YYYY
Ministry type
Photo Upload
Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 15 MB.
Images should be a minimum of 800 X 600 pixels.
Photo Caption
Photo Credit