2025 Renewal

First Name *

Last Name *

Email Address *

Church / Ministry / Work Name *

Work / Ministerial Position *

Church / Ministry / Work Address

Please inform your business address here.

Work - Address Line 1 *

Work - Address Line 2

Work - City *

Work - Postal/Zip Code *

Work - Province/State *

Work - Country

Please inform your personal address here

Address Line 1 *

Address Line 2

City *

Postal/Zip Code *

Province/State

Country *

Home Phone

Cell Phone

Please attach a headshot below.

Your Photo

Next Step

License Type for 2025 * *

Registered Clergy Number

Has your ministry role changed since the last renewal period? * *

New Ministry Role

Sponsor's Name *

Sponsor's Email Address *

Sponsor's Phone Number

Your membership will be finalized once both payment & sponsor renewal forms have been received by the Anchor office

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