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All Membership Applications and Fact Sheets should be mailed to the address on the bottom of this page. An application will not be reviewed without an application fee and a completed “Application” and “Fact Sheet”. Please note that the $50 application fee is strickly nonrefundable.This application must be completely filled out. Please respond to any item that does not apply to you by inserting “Not Applicable” or “N.A.”
Date
Name
Birth Date
Home Phone
Personal E-Mail
Home Address
City
State/Country
Province
Postal Code
Please complete the following information as it applies to your status as a Pastor, head of a ministry, or licensed minister.
Church/Ministry Name
Church Phone
Church Fax
Church E-Mail
Home Address
City
State/Country
Province
Postal Code
Current Denominational Affiliation
Pastor’s Name
(if other than yourself)
Current Covering/Affiliation
Former Covering/Affiliation
How did you hear about the Council?
If by personal recommendation, who recommended you to theCouncil?
Initials