How old are you?

    Thank you for your application. Please note that Senior Pastors and Spouses must meet the following requirements to be eligible for membership in Churches United. Please check each box to confirm you meet the requirements.*



    Senior Pastor Information

    Title: *

    First Name: *

    Last Name: *

    Date of Birth: *

    Senior Pastor E-mail: *

    Senior Pastor Cell Phone Number: *

    How many years have you been a Pastor? *

    Please provide your bio. *

    How did you learn about Churches United? *

    Spouse Information

    Title:

    First Name:

    Last Name:

    Date of Birth:

    Spouse E-mail:

    Spouse Cell Phone Number:

    Home Address

    Street Address: *

    City: *

    State / Province: *

    Zip: *

    Country: *

    Church Information

    Church Name: *

    Street Address: *

    City: *

    State / Province: *

    Zip: *

    Country: *

    Phone Number: *

    Size of Church Membership: *

    Website:

    Social Media (Facebook, Instagram, Twitter, etc.):

    Mailing Address (If different from church address):

    Street Address:

    City:

    State / Province:

    Zip:

    Country: