Renewal Forms
2012 FCMI Individual Renewal Form
(Membership is from 1/1/2012 to 12/31/2012) (Just print to use)
Last name:___________________________________________
First name:___________________________________________
Home Address:_________________________________________
City:_________________________State:_____ ZIP:______
Telephone: (____)_____________________________
Spouses Name:________________________________
Ministry Name:___________________________________________
Ministry Address:_________________________________________
MinistryCity:______________________State:_____ZIP:__
Ministry Telephone: (_____)___________________
Ministry Position: (pastor, teacher, etc)_________________
Fax:(____)________________
Email:___________________________________________
Web site url:http://_________________________________________
Return renewal form and $50.00 to:
FCMI * PO Box 2165 * Reidsville, GA 30453
2012 FCMI Church Renewal Form
(due from 1/1/2012 to 12/31/2012 ) (Just print to use)
Church name:___________________________________________________
Church (location) Address:________________________________________
City:_______________________________ State:_____ ZIP:__________
Church Mailing Address:__________________________________________
City:_______________________________ State:_________ ZIP:________
Church Telephone: (____)_____________________________
Pastor’s Name:_________________________________________________
Church Fax:(____)________________
Email:________________________________________________________
Web site url: http://______________________________________________
Return renewal form and dues* to:
FCMI
PO Box 2165
Reidsville, GA 30453
*(NOTE)
Dues for churches are $$50.00 for churches with 1-25 members; $75.00 - 26-50 members; $100.00 - 51-75; $150.00 for 76-199 -and $200.00 with 200 and more members.