Antioch Baptist Church North
Membership Update Form
Email *
Today's date *
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DD
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First Name *
Middle Name *
(if Applicable)
Last Name *
Address *
City *
State *
Zip Code *
Home Phone Number *
Cell Phone Number *
Best Contact Phone Number *
I authorize Antioch Baptist Church North to send me updates and information via text and email.
Are you a member? *
Member Number (if known)
Month of birth
Day of birth
What ministries/auxiliaries are you a member of?
What ministries/auxiliaries would you like more information about?
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