Membership Application

First Name

Last Name

Street Address

City

State

ZIP

Email Address

Date of Birth

Cell Phone

Spouse Name

Spouse Email Address

Spouse Date of Birth

Anniversary date *

Spouse Cell Phone

Pastor NamePastor or COM name reference

Name of ChurchName of church and demonination

Street Address

City

State

ZIP

Pastor Phone

Church Phone

Check type of projects in which you have participatedCOMNAMBIMBLocal Church ProjectState ConventionOtherHave you participated in a mission project.

List Areas Of Special TrainingCampground MinistriesChurch PlantingConstruction / MaintanceDisaster Relief / RecoveryFairs, Festivals, Special EventsCommunity Survey, RevivalsPersonal TestimonyState Convention BoothsVBS, Bible StudyClowns, FacepaintingRaceway MinistriesSeaman’s MinistriesOther

First Name

Last Name

Emergency Contact Phone

Campers On Mission Statement of Faith

SignatureBy typing my name in the signature box, I agree with COM Statement of Faith and will endeavor to live my life guided by the scripture it is based on.

Spouse SignatureBy typing my name in the signature box, I agree with COM Statement of Faith and will endeavor to live my life guided by the scripture it is based on.

Date

Scroll to Top