FBC Marilla - Im-new-Appform

New Member? Fill out this form!

First Name

Last Name

Children's Names

Put email in directory?
Yes
No

Birthday(s)

Address 1

Address 2

Country

City

State

Zip/Postal Code

Phone Number

Put phone in directory?
Yes
No

Anniversary

Would you like to be put on the prayer list to receive prayer requests?
By Phone
By Email

Have you received a church directory?
Yes
No