Antioch Missionary Baptist Church : Member Contact Information

Please include at least one piece of contact information in order to be included in the online Member Directory.

Personal Information

Next of Kin

Please let us know who to contact in case of Emergency. We will not make this information public, or contact this person unnecessarily.
Your Next-of-Kin's Full Name
What is your relationship to the next of kin?
Your Next-of-Kin's Phone Number

Listing Options

If you choose to have your information posted to the Online Directory of the church's web site, the information you provide will only be seen by full members of Antioch who are also verified and registered users of the church web site. The information will not be visible to the general public.
Would you like your contact information to be listed on the web site?(required)
Where do you work?
Please check this box if you want us to show where you work, on the web site?
MessageInclude any message you wish to submit to the Membership Committee.

Security Verification

Member Contact Information