printable membership
Membership Form
Type of Membership: Personal___ Church___ New___ Renewal___
Preferred mailing address: Residence___ Church___
Name:___________________________________________________________
Home Address:___________________________________________________
City:________________________ State_________ Zip Code______+____
Phone ______________________ E-mail __________________
Church Name :____________________________________________________
Church Address:___________________________________________________
City:________________________State_________Zip Code____________+________
Phone______________________ E-mail____________________________________
I would like to become a member or renew my current membership. Choose your level of support.
Regular ($50)___ Sustaining ($100)___ Patron ($150)___ Life Membership ($600)___
Enclosed is my check in the amount of $__________ Date___________ ck#______
Please mail this form and your check payable to FABM to:
FABM Executive Secretary
3300 Fairlawn Dr
Columbus, IN 47203
Refund Policy: Membership Fees are non-refundable.
For Office Use-Paid_______Received_______Deposited_______Computer_______Library_______Acknowledged______