Back

Next

NATIVE AMERICAN MINISTERIAL ASSOCIATION
MEMBERSHIP APPLICATION

1. PERSONAL DATA

NAME(Last) (First) (Middle)


HOME ADDRESS City State Zip

( ) ( )
Home Phone Work Phone E-mail address


     __F/M__ _____/_____/______ __S__Eng__Mar__Sep__Div__
       Sex Date of Birth Marital Status (circle one)

     ______________________________________ ___________________
      Native-American Tribal Affiliation (if applicable) Country of Citizenship

2. CHURCH AFFILIATION (Recommended)

List the name of the Church which you are currently a member or attend.
                                                                                                       ( )
Name of Church Senior Pastor Phone


Address City State Zip

                                                                                                                                          
      Years Attended Positions Held

100. YOUR MINISTRY

If you are involved in a Christian ministry, please answer the following.

Name of Ministry Address

                                                                                               ( )
City State Zip Phone


Years Involved Positions Held