[{"Value":"","Discard":false,"Expires":9999999999}] Member Registration – Galilee Missionary Baptist Church Skip to content

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Media
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Registrations

Member Registration

Has any of the information you entered in the previous year changed? *yesno

Member # *

First Name *

Last Name *

Address 1

Address 2

City

State/Province

ZIP / Postal Code

Home Phone

Cell Phone

Email Address

Birthday

Month

Day

Year

Gender

Martial Status

RetireeYesNo

College StudentYesNo

Military PersonnelYesNo

Home Bound/Nursing HomeYesNo

Emergency Name *

Emergency Relationship *

Emergency Phone *

NotificationsYesNoWould you like to receive notifications regarding church information?

Notification Preference

Is the registrant between the ages of 1-19?Yesno

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Affiliations

Business Owners
National Baptist Convention, USA, Inc
Michigan District Baptist Association
Chapel Vision Community Development Corporation
Baptist, Missionary and Educational Convention of Michigan

Contact Information

313-372-1270
admin@galileedetroit.org
5251 East Outer Drive, Detroit, MI 48234

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