New Member Application

Please read the "What We Believe" section on our website before filling out this application

Name *

Street Address *

City *

State *

Zip Code *

NC County of Residence *

Cell Phone *

Email Address *

Spouse Name

Spouse Cell Phone

Spouse Email Address

Name of the Church you attendName of church and demonination

Emergency Contact Name *Person to contact if you are not able to communicate.

Emergency Contact Phone *

Check type of projects in which you have participated

COMNAMBIMBLocal Church ProjectState ConventionOtherHave you participated in a mission project.

List Areas Of Special Training

Campground MinistriesChurch PlantingConstruction / MaintanceDisaster Relief / RecoveryFairs, Festivals, Special EventsCommunity Survey, RevivalsPersonal TestimonyState Convention BoothsVBS, Bible StudyClowns, FacepaintingRaceway MinistriesSeaman's MinistriesOther

SignatureBy typing my name in the signature box: I have read and agree with the COM Statement of Beliefs found on this website.

Spouse SignatureBy typing my name in the signature box: I have read and agree with the COM Statement of Beliefs found on this website.

Date Signed and Submitted

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