Faith Landmarks Ministries

Member Services
> Church Forms
> Leader Login

Contact Information
phone: (804) 262-7104
fax: (804) 266-7127
events hotline: (804) 515-5860
24/7 prayer line: 866-faith-21
> email us

Head of Household Information:
Title:
First Name:
Middle Name:
Last Name:
Suffix:
"Goes By" Name:
Gender:	Male Female
Date of Birth:	(MM/DD/YYYY)
Address Line 1:
Address Line 2:
City:
State:	Zip:
Home Phone:
Work Phone:
Mobile Phone:
Email:
Contributions:	Individual Combined with Spouse
Born Again date: (if unknown, please estimate)
Spouse Information (if applicable) > skip this section
Title:
First Name:
Middle Name:
Last Name:
Suffix:
"Goes By" Name:
Gender:	Male Female
Home Phone:
Work Phone:
Mobile Phone:
Email:
Date of Birth:	(MM/DD/YYYY)
Born Again date: (if unknown, please estimate)
Are you both becoming members of FLM?	Yes No
Child(ren) Information (if applicable) > skip this section
Child 1:
First Name:
Middle Name:
Last Name:
Suffix:
"Goes By" Name:
Gender:	Male Female
Date of Birth:	(MM/DD/YYYY)
Child 2:
First Name:
Middle Name:
Last Name:
Suffix:
"Goes By" Name:
Gender:	Male Female
Date of Birth:	(MM/DD/YYYY)
Child 3:
First Name:
Middle Name:
Last Name:
Suffix:
"Goes By" Name:
Gender:	Male Female
Date of Birth:	(MM/DD/YYYY)
Child 4:
First Name:
Middle Name:
Last Name:
Suffix:
"Goes By" Name:
Gender:	Male Female
Date of Birth:	(MM/DD/YYYY)
Child 5:
First Name:
Middle Name:
Last Name:
Suffix:
"Goes By" Name:
Gender:	Male Female
Date of Birth:	(MM/DD/YYYY)

Confirmations
I (we) have attended or viewed the Membership Class. Yes No
I (we) would like to become a member(s) of Faith Landmarks Ministries. Yes No, just add me to your mailing list.
I have viewed the Membership video, in its entirety, and hereby agree with the tenants of faith, and teaching, and commit to be a member of Faith Landmarks Ministries. Yes No