AIM Application

AIM Application
Applicant Title & Name

TitleFirst NameLast Name
Spouse Name

PrefixFirst NameLast Name
Applicant Date Of Birth

MonthDayYear
Spouse Date Of Birth

MonthDayYear
Wedding Anniversary Date

MonthDayYear
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Church Office Number

Area CodePhone Number
Email Address
Alternate Email Address
What position do you currently hold in ministry?
What's your spouse position(s) in ministry?
How long?
Are you full-time in Ministry?
Church Name
Church Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Church Phone Number

Area CodePhone Number
Church Fax Number

Area CodePhone Number
Church Physical Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long has this Ministry been in existence?
Are you the Founder?
Please describe the Ministry Vision:
Give a brief history of the ministry:
What Church/Organization Licensed Your Ministry?
Church/Organization Name
Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Minister's Name

First NameLast Name
Under what Church/Organization was your Ministry Ordained?
Church/Organization Name
Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Minister's Name

First NameLast Name
How Are You Applying?
Applying as:
Please list three Ministerial References and give at least two contact numbers for each reference.(Must have known for two years or more)
1. Minister's Name

First NameLast Name
Church Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Church Number

Area CodePhone Number
Home Number

Area CodePhone Number
Cell Number

Area CodePhone Number
Fax Number

Area CodePhone Number
Email Address
2. Minister's Name

First NameLast Name
Church Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Church Number

Area CodePhone Number
Home Number

Area CodePhone Number
Cell Number

Area CodePhone Number
Fax Number

Area CodePhone Number
Email Address
3. Minister's Name

First NameLast Name
Church Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Church Number

Area CodePhone Number
Home Number

Area CodePhone Number
Cell Number

Area CodePhone Number
Fax Number

Area CodePhone Number
Email Address
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Return Application Fee and Annual Membership Fee to P. O. Box 670167, Houston, TX 77267. Or after you submit the form, you will be directed to a form to use your credit card.Application Fee is $50.00. Annual Membership Fee is $100.00. Refer any questions to 281-875-4448

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AIM Application Fee

$50.00 Quantity

Total

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First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

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AIM Application

What Church/Organization Licensed Your Ministry?

Under what Church/Organization was your Ministry Ordained?

How Are You Applying?

Please list three Ministerial References and give at least two contact numbers for each reference.(Must have known for two years or more)

Return Application Fee and Annual Membership Fee to P. O. Box 670167, Houston, TX 77267. Or after you submit the form, you will be directed to a form to use your credit card.Application Fee is $50.00. Annual Membership Fee is $100.00. Refer any questions to 281-875-4448

My Products