Membership -

Membership Type *

Identify which designation you would like to join the church under

Your Name *

Enter your full name

Your Email *

Street Address *

Provide street address and apartment number

City, State, Zip Code *

Cell Phone Number *

Home Phone Number

Birthdate (MM/DD/YYYY) *

Enter your birthday in MM/DD/YYYY format

Sex

Marital Status

Employer

Please enter the name of your employer. If unemployed type N/A.

Job Title

Please enter your job title. If unemployed, type unemployed. If retired, type retired.

How would you like to share your talents to work with the church?

Please let us know what gifts/talents you may have and how you would like to use them to uplift our church/community.

Emergency Contact's Name *

Name of your emergency contact

Emergency Contact's Number *

Emergency contact's phone number

Relationship

Relationship to your emergency contact

How did you hear about Brown Memorial Baptist Church?

Membership