Application
Membership Level
*
General Membership $50 (Valid for 12 Months)
Clergy Membership $100 (Valid for 12 Months
Application Type
*
Member
Minister in Training
I am Called to be an Ordained Minister
I am an Ordained Minister
In what year were you Ordained?
*
Which Body performed your Ordination?
*
What Credential would you like us to use on your ID Card?
*
Example: Ordained Minister
Your Name
*
First Name
Last Name
Your Mailing Address
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Street Address
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State
Zip Code
Email
*
Phone Number
*
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Area Code
Phone Number
Last 4 of Your Social Security Number
*
Date of Birth
*
Month Day Year
Gender
*
Male
Female
How did you hear about us?
*
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