Please fill out the application and and click "SEND" to send it to the WME office.

First Name:

Last Name:

Occupation:

Street Address 1:

Street Address 2:

City:

State:

Zip Code:

Email Address:

Confirm Email Address:

Home Phone:

Cell Phone:

Work Phone:

Fax:

Credential:

Web Address:

Link My Website with WME website:
Yes No

Ordained/Licensed Renewal: Complete the following if you are renewing and are ordained or licensed.

Pastor:

Name of Church:

Missionary:

Name of Ministry:

Evangelist:

Name of Pastor:

Other:

What Capacity In Church:

Christian Worker: Complete the following if you are renewing as a Christian worker.

Name Of Your Pastor:

Church:

Church Phone Number:

In the last year have you changed any of the following?: (if yes, explain below).

Churches:

Explain:

Marital Status:

Explain:

Ministry:

Explain: