.


Fill out and submit to join Amite Baptist Church.
Date
Name
Address
City and Zip Code
Home Phone Number
Cell Phone Number
Email Address
Birthdate
School grade (if applicable)
Sex	male female
I would like to become a member by	confession of faith and baptism letter statement
If by letter, where is your current membership?
Are there other members of your family who would like to become members of Amite Baptist?	yes no
If yes, please list names and ages