Fairview Loop Baptist Church

Member's Info

If you do not yet have a user account, please fill out the form below to request membership. After you submit your information, it will have to be approved by a site administrator before your user account is active. If your information has already been approved, please login above.

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First Name *

Last Name *

Address Line 1

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Zip Code

Home Phone

Office Phone

Cell Phone

Email Address *

Birthday

Wedding Anniversary

Extra Details

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I would like to receive member information and news via email.

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I DO NOT want any of this information available to everyone in the member area. I only want the first and last name typed in above to be available under my family's information (ideal for children under 13).

All of this information is correct and truthful. I am at least 13 years old or have verifiable permission to submit this information. *