Membership Type Membership Type New Member Membership renewal

Fees Fees Individual membership $35 Church or Ministry membership $60

Prefix PrefixDr.PastorRev.Mr.Mrs.

First Name

Last Name

Website

Email

Church/Ministry Name

Year established

Church/Ministry Address

Province

City

Postal Code

Church/Ministry Affiliation

Position Position Pastor in charge Minister Associate Pastor Other

Other Position

Do you believe in the baptism of the Holy Spirit? Do you believe in the baptism of the Holy Spirit? Yes No

Which area are you gifted? (check all that applies) Which area are you gifted? (check all that applies) Discernment Knowledge Wisdom Counselling Prophecy Evangelism Praying Healing Hospitality/Service Teaching

Other

Payment Method Payment Method Paypal (Debit/Credit)