Member and Spouse Renewal

Use this form for Member and Spouse renewal - A$220 inc GST.

Both Husband and Wife must be existing members

When you submit the renewal, you will be taken to our secure Paypal site, where you can use your Visa or Mastercard, or your Paypal account.

By submitting this form, you agree to our site Terms of Use

Title

First Name:
*
Spouse First Name
*
Last Name:
*
Email Address:
*
Membership Number (If Known)
Spouse Membership Number (If Known)
Approximate Number of People Ministered to in 2009
Approximate Number of People Saved in 2009
Special Events or Accomplishments
Major Changes in Ministry
Are there any changes to your Membership Directory Details?

Only complete the remaining fields if there are changes
ICFM will publish a maximum of 3 ministry Classifications
1st Ministry Classification

2nd Ministry Classification

3rd Ministry Classification

Spouse 1st Ministry Classification

Spouse 2nd Ministry Classification

Spouse 3rd Ministry Classification

Ministry or Church Name
Street Address or PO Box
Suburb Town or City
Post Code
State

Country

Office Phone
Fax
Comments
Security code:
*
Do not enter anything in this field:

* indicates a required field

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