Membership Request
Please fill in this form if you are interested in becoming a member of Lost Mountain Baptist Church.
Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Email *
Your answer
Address *
Your answer
Phone *
Please list if it is a mobile or home phone.
Your answer
I desire to make the following public statement *
Required
I desire to join Lost Mountain *
Required
Previous Church *
This is primarily used if you checked "By Letter" in previous question.
Your answer
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This form was created inside of Lost Mountain Baptist Church. Report Abuse - Terms of Service - Additional Terms