Form Type: 
MINISTRY TYPE:     Church   Outreach   Itinerant Minister   Helps   Other
MINISTRY - GENERAL INFORMATION
Title/Name:
Spouse's Title/Name:
Birthday (month/day):
Spouse's Birthday (month/day):
Wedding Anniversary:
(month/day/year)   
CONTACT & MAILING INFORMATION
Home Address:
City:
State:
Zip Code:
Country:
Home Telephone:
Fax:
Ministry Name:
Ministry Street Address:
City:
State:
Zip Code:
Ministry Telephone:
Fax:
Min. Mailing Address:
City:
State:
Zip Code:
Email:
Website:
Assistant's Name:
Admin. Assistant's Name:
Year Ministry Established:
# of Members:
# of Partners:
MINISTRY - DETAILED INFORMATION
How did you hear about us?   TV   Faith Alive Newsletter   Website   Word of Mouth   Other
Are there any other organization(s) with which you are associated?  
Why do you want to become a part of FCM International?  What do you expect to receive?  
What is your ministry's main topic of emphasis (i.e., healing, prosperity, community development, etc.)?  
What area(s) of your ministry need further development (i.e., administration, growth, youth ministry, website, etc.)? 
Additional Comments:
METHOD OF PAYMENT
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Expiry Date: Month Year