New Member Registration Form

Address *

SPOUSE INFORMATION (if applicable)
If you are not married, please click "Next" at the bottom of this page and proceed to the next section.
Title:
First Name:
Middle Name:
Last Name:
Suffix:
"Goes By" Name:
Gender:

Male Female
Date of Birth:

Month Day Year
SPOUSE PHONE/E-MAIL INFORMATION
Preferred Phone Number:
Phone Type:

Home Cellular Work
E-mail:
SPOUSE OTHER INFORMATION
Born-Again Date (please estimate):

Month Day Year
Are you both becoming members of FLM?

Yes No
Spouse profile photo upload:

CHILD(REN) INFORMATION (if applicable)
If you do not have any children, please click "Next" at the bottom of this page and proceed to the next section.
CHILD 1:
Full Name (first, middle, and last):
Suffix:
"Goes By" Name:
Gender:

Male Female
Date of Birth:

Month Day Year
Child 1 profile photo upload:
CHILD 2:
Full Name (first, middle, and last):
Suffix:
"Goes By" Name:
Gender:

Male Female
Date of Birth:

Month Day Year
Child 2 profile photo upload:
CHILD 3:
Full Name (first, middle, and last):
Suffix:
"Goes By" Name:
Gender:

Male Female
Date of Birth:

Month Day Year
Child 3 profile photo upload:
For additional children, please list their full names, gender and dates of birth in this box:

CONFIRMATIONS
I (we) have attended/viewed the Membership Class: *

Yes No
I (we) are born-again Christians: *

Yes No
I (we) would like to become members of Faith Landmarks Ministries: *

Yes No, just add me to your mailing list
I desire to become a member of Faith Landmarks Ministries. I confess Jesus Christ as my Lord and Savior, and I have read, understand and agree with the Tenets of Faith of FLM. I desire to commit myself to join this local body, submitting myself to the leadership and pastoral authority of FLM to carry out the commissions of Jesus Christ.
I affix my digital signature to this form that I agree with all the statements made herein, and regarding the tenants of faith. *

Yes
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