| Membership Renewals

2010 Ordination/Licensing/Membership Renewal Application

Please complete the following form in its entirety by December 31, 2009. All applications received after December 31, 2009 will be assessed a late fee of $30.00. If renewal forms and fees are not received by January 31, 2010, your member ship will be canceled. AFCM reserves the right to cancel membership status if the requirement set by the Committee of Management are not met.
Married couples must complete separate forms.

* Required

Personal Information
Title
First Name *	Last Name *
Spouse's Name	Is your spouse a member of AFCM? Yes No
Home Address *	City *
State *	Zipcode/Postcode *
Country *
Email Address *
Home Phone Number *	Mobile Phone Number *
Fax Number
Church or Ministry Information
Church or Ministry Name	Publish as a branch on the website? Yes No
Church or Ministry Address	City
State	Postcode
Website
At this time, are you involved in full-time ministry? * Yes No	Is your ministry the sole means of your income? * Yes No
What field of ministry are you currently involved in? * Pastor Itinerent Missionarly (living on foreign soil) Missionary (living on home soil) Other (please specify) Other Ministry Field or N/A *
If you are an Itinerant minister, please tick your area of specialty. Teaching Evangelism Music Children Youth
If you are a missionary, which country?
Home Church (if not senior Pastor)	Pastor (if not senior Pastor)

Which AFCM meetings did you attend this year? * Family Reunion 2009 Ladies' Retreat Shine09 (youth camp) State Regional Other I was unable to attend any AFCM meetings this year.
Did you financially support AFCM this year? * Yes No
Have you been in touch with another member of AFCM in the past year? * Yes No
Understanding that a Minister of the Gospel must maintain the highest moral and ethical standards, do you feel there is any area of your personal life (i.e. smoking, illegal drugs, alcohol, adultery, homosexuality, etc.) that would hinder your Ministry? (If yes, please attach a detailed explanation below.) Yes No
Activites and Goals
Please give a brief summary of your ministry activities this past year. Include number of people saved and healed, special outreach or activities, or countries your church or ministry was involved in. *
What are your personal and/or ministry goals this year? *
What can AFCM do to better assist you? *
What areas would you like us to agree with you in prayer? *

___________________________________________________________ PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING. I agree with the Tenets of Faith and Ministerial Ethics set forth by the Association of Faith Churches and Ministers. I submit the the spiritual authority and guidelines of AFCM. If, at any time, I feel I can no longer agree with the beliefs and practices of this organisation, or if it is requested by those in authority for any reason, I will forfeit and return my ministerial credentials (certificates and wallet card) to AFCM. By typing my name in the Digital Signature Box Below I agree with the conditions set forth in the paragraphs above and I hereby state that all the information contained on the renewal is correct and true.
Digital Signature *	Date *
___________________________________________________________
Renewal Fees * Please select the appropriate fee. Married couple pricing does not apply unless BOTH individuals are applying for renewal. Ordination/Licensing Renewal--Married $55.00 (per person) Ordination/Licensing Renewal--Single $85.00 NOTE: If you are licensed or ordained with AFCM, you are automatically a member and pay only the Ordination/Licensing fee. Membership Renewal--Married $42.50 (per person) Membership Renewal--Single $70.00 **Renewals submitted after December 31, 2009 should include a $30 late fee.

Payment Information
Billing Address *	City *
State *	Zipcode/Postcode *
Country *
Name on Card *
Card Number *
Card Expiry * *
Card Type * *
CCV Number *
Amount *

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