BEKA Licensing & Clergy Payment Form

BEKA Licensing & Clergy Payment Form

BEKA Licensing Fees

Licensing & Membership Fees

Licensing Fees

Pastors

$250.00

Elders

$150.00

Prophets, Evangelist, Ministers

$75.00

Total

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

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Title as you would like for it to appear on your membership card.
Comments
Should be Empty: