Standard Clergy Listing - Permission to appear in directory

CLERGY DIRECTORY STANDARD LISTING

USE THIS FORM TO SUBMIT YOUR INFORMATION FOR YOUR STANDARD PROFILE LISTING
Today's Date *

Month Day Year
Date
FULL Name Including your title: (Minister, Priest/Priestess/Bishop) *
please use the name on your ordination certificate
Best contact Phone Number (Not included in listing just for MMI Reference if we need to call you) *

Area Code Phone Number
Best contact Email (Note - your email will not be published) *

Confirmation Email example@example.com
Do you wish to be listed in the Clergy Directory *

YES, please include me in the Clergy Directory NO, I prefer not to be included in the Clergy Directory
Where are you Located? Please enter preferred location: Enter City, State, or Country location information
City, State and Country
Please pick all that apply to your Ministry - at least one is required.

Astrology and Spiritual Readings Energetic and Hands-on Healing Life Coaching and Relationship Counseling Spiritual Workshops and Gatherings Weddings, Celebrations and Ceremonies Spiritual Hospice and Grief Counseling On-line Workshops and Learning Events Ordination Mentoring and Ceremony Other Ministerial Outreach
PLEASE PROVIDE THE URL TO THE LINK YOU WOULD LIKE OTHERS TO FIND YOU WHEN THEY CLICK THE "VIEW CLERGY" BUTTON.
INSERT "VIEW CLERGY" BUTTON LINK
ENTER URL HERE
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IF YOU DO NOT HAVE A FULL FACE PROFILE IMAGE, WE WILL USE THE MADONNA INTERFAITH COMMUNITY LOGO.
Full Face Image for PROFILE IMAGE: Dimensions at least 250 by 250 pixels - If larger we can reduce

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CLERGY DIRECTORY STANDARD LISTING

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