Membership Renewal

AFCM International

Association of Faith Churches and Ministers
PO Box 1918
Willmar, MN 56201-1918

Phone (320) 235-3838
Fax (320) 235-1802

Membership Renewal Application

Please complete this form by December 31. The renewal form and dues must be sent together or your renewal will not be accepted. Married couples must complete separate forms. Any member renewing after December 31 will be assessed a late fee of $25.00. If we do not receive renewal form(s) and dues by January 31, your membership with AFCM will be canceled for non-payment. AFCM reserves the right to cancel membership status if requirements set up by the Board of Trustees are not met.

Please Note: (*) Indicates a Required Field, the form will not submit unless these fields are filled in.

*First Name: A value is required.	*Last Name: A value is required.	*Church or Ministry Name: A value is required.	Preferred Name/Title:
Spouse's Name:	Spouse's Birthday:	Your Birthday:	Wedding Anniversary:

*Office Address (For missionaries, please put a stateside address)		*Home Address (For missionaries, please put a foreign address)




Check here if this is a new address		Check here if this is a new address
* To which adddress do you prefer mail to be sent? Office or Home
*Office Phone:	Office Fax:	*Office E-mail: Invalid format.A value is required.
*Home Phone:	Home Fax:	Home E-mail: Invalid format.
Invalid format.A value is required.*Cell Phone: A value is required.	Invalid format.	Website Address:

** If you are in TRANSITION at this time, please explain:

*Is your ministry the sole means of your support: Yes No

*At this time are you involved in full time ministry: Yes No

*Home Church:

A value is required.

*Pastor:

A value is required.

AFCM Leadership that I have been contact with:

*How many AFCM meetings did you attend this year:

*Which annual AFCM meeting(s) did you attend this year?
Family Reunion(US) Family Reunion(Africa)
Family Reunion(Peru) Overnighter Regional Meetings

*Did you financially support AFCM this past year: Yes No

With what other ministerial organizations are you Licensed and/or Ordained:

What can AFCM do to better assist you?

Please give a brief summary of your ministry activities this past year including healings, salvations, etc., and special outreaches of your church or ministry.

In what countries have you ministered this past year?

To what countries do you anticipate traveling in the upcoming year?

*In the past year, have you

Yes No

Committed or been accused, questioned, or investigated for child abuse, child neglect, or child molestation?

Yes No

Committed or been accused, questioned, or investigated for spousal abuse?

Yes No

Used any form of tobacco products, alcohol (including wine), or illegal drugs?

Yes No

Been convicted of a felony?

Yes No

Been involved in homosexual activities?

Yes No

Been involved in an extramarital relationship/affair?

Yes No

Is there anything in your life that would hinder your ministry at this time?

If you have answered yes to any of the above questions, please give an explanation including
dates and details:

I acknowledge that I agree with the Tenets of Faith and Ministerial Ethics set forth by the Association of Faith Churches and Ministers.

I hereby state my willingness to submit to 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 organization, or if it is requested by those in authority for any reason, I will forfeit and return my ministerial credentials (certificate and wallet card) to AFCM.

I understand that it is a requirement for all AFCM affiliated churches, ministries, and organizations to conduct thorough background checks on all employees and volunteers that work in the children and youth departments. Failure to do so will be cause for dismissal from AFCM.

I understand this application will be held in confidence. Only those persons with a need to know will review it. I grant AFCM and its leadership permission to verify information on this application to include a criminal background check and credit history.

I understand that AFCM gives an update on all members annually. This includes not only active members, but also those whose memberships have "Lapsed" due to non-renewal, those who have "Withdrawn" from, or are "Dismissed" from AFCM during the course of the year. I understand that if my membership lapses, I withdraw, or am dismissed from AFCM my name will appear in the appropriate category in the next AFCM Directory.

By signing this Renewal Application 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.

*Type your name here to agree to the above: A value is required.

Invalid format.

RENEWAL FEES

Check only the fees that apply to you:

$25.00 MISSIONARY - LIVING ON FOREIGN SOIL and/or FOREIGN MEMBER Ordination or Licensing Renewal

$100.00 Ordination or Licensing Renewal - ( If you are licensed or ordained with AFCM, you are automatically a member and pay only the $100.00 fee.)

$75.00 Membership Only Renewal - (For those who are ordained through another organization, but members only with AFCM)

$50.00 Christian Worker Status Renewal

$25.00 Spouse Renewal

$25.00 Add an additional fee for Renewals after December 31

*Payment Options

Credit or Debit Card

Card Number:

Expiration Date:

CID Number(Located on the back of your Credit Card usually in the signature area)

By typing your name in the box below I authorize AFCM/Jim Kaseman Ministries to charge my credit card for the amount above for renewal fees:

Check

Information as printed on the check:

Name:

Bank Name:

Address:

City:

State:

Zip:

Routing Number:

Account Number:

Check Number:

Please be sure to write VOID on the check and securely dispose of the check as we will use the numbers to charge you account.

** Note: If your form does not submit, then you have forgotten a required field. Please go back though the form and look for highlighted fields that say (Required).

Pastor	Asst. Pastor	Missionary(residing on foreign soil)
Music	Itinerant*	Missionary(residing in your home country)
Youth Minister	Children’s Minister	Helps	Chaplain
Transition**