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Join Our Church Family
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We are so excited about your desire to join our BMBC church family! This form is provided online for your convenience. Please fill out this short information form to become a BMBC member. Someone from the church will contact you after the form is submitted.
Membership Interest Entry
First Name
First Name is required.
Last Name
Last Name is required.
Email
Email address is not valid
Email is required.
Mobile Phone
Mobile Phone is required.
Birthdate
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1914
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1912
1911
1910
1909
1908
1907
1906
1905
1904
1903
1902
1901
1900
Birthdate cannot be a future date.
Gender
Male
Female
Gender is required.
Show Spouse
Address
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
Marital Status
Married
Single
Divorced
Widowed
Marital Status is required.
Home Phone Number
Have you been baptized?
No
Yes
Have you been baptized? is required.
I want to be Baptized
No
Yes
I want to be Baptized is required.
Occupation
Occupation is required.
Employer
Employer is required.
Is your spouse joining with you?
No
Yes
Is your spouse joining with you? is required.
Do you have children joining with you?
No
Yes
Do you have children joining with you? is required.
Emergency Contact First Name
Emergency Contact Last Name
Emergency Contact #
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