AEGA Ministries International Church & Ministry Affiliation

AEGA MINISTRIES INTERNATIONAL | CHURCH & MINISTRY AFFILIATION

(For Churches & Ministries Based Outside of the United States)

Church/Ministry Name

Address

Church/Ministry Phone

Church/Ministry Fax

E-mail Address

Pastor/Director Name

Resident Address

Resident Phone

Pastor/Director Date Of Birth

MonthDayYear

Ordained MinisterOther

If Other Explain

Children's OrphanageSchoolsFeeding ProgramsOther

If Other Explain

SPECIAL NOTE: (Stipulations)

1) The affiliating organization is NOT PERMITTED to use the AEGA name or logo on any of its literature or advertising (unless specific written permission is granted by the AEGA Headquarters).

2) The report of any action on the part of this organization which is not glorifying to the name of Jesus Christ shall be investigated and may result in the voiding of this affiliation.

I attest that the above information is true and accurate to the best of my knowledge, and I have read, understand and agree to the above stated stipulations.

signature

Signature Date

MonthDayYear

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