Application for FCMI Church Affiliation  (To use this form, just print)


Date of application:________________

(Instructions: A copy of  Church Constitution, and application fee must 
be included as follows: Dues are $1.00 per member of your church.
Example: If your church has 33 members, you dues would be $33.00.
If your church has 126 members, your dues would be $126.00.)


Employer's Identification Number ___________________ 

Do you have tax exempt status with IRS? _______ 

Church Name:__________________________________     Phone:______________________

Street Address:______________________________________________________

City:__________________________    State:__________     ZIP:___________________

Mailing Address:____________________________________________________________

City:___________________________    State:____________   ZIP:_______________

Pastor:___________________________________     Phone:__________________________

Address:__________________________________________________________

City:____________________________    State:______________    ZIP:_____________

Email:______________________________   Web site:_______________________________

Church Treasurer:_______________________    Church Secretary:_________________________

Is the Church Incorporated?________  When?______________   What State?________________

Empl. Tax ID#__________________________________

Do you have a Church Constitution?________  By Laws?______  Statement of Faith?_______

Does your church keep records of Finances and Minutes?_______________________  
If not, will you do so?____________

Do you have a church membership listing?____________  Number of members:_____________

Average church attendance:____________  

Will you do your best to an active part of the FCMI fellowship?______________

Do you plan to grant Ministerial Ordinations?___________________

Pastor's Signature:_____________________   Secretary's Signature:______________________

FCMI Member recommending your church for affiliation:_______________________________________

Signature of FCMI Member recommending your church:_______________________________________________

Phone:__________________________   Address:________________________________________________

City:_______________________________________    State:________    ZIP:_________________

(FCMI recommending member must sign this application before it can be processed.)