MembershipRenewal

CFNI credentials are only valid with current CFN FMC membership.

Members with CFNI credentials must maintain active membership with the FMC to have the legal power to perform marriages, receive minister’s tax allowances, and maintain Social Security exemption.

Renewal fee: $ 110.00. Married couples if both are members: $ 195.00. Add $ 25 late fee if renewal is submitted 45 days past expiration.

Check or money order should be made out toCFN FMC

and mailed to:CFN FMC3404 Conway St. Dallas, TX75224.

You may pay with Credit Card (VISA, MasterCard, Discover or AMEX) by calling us at:214 302-6459, completing credit card payment information below or by using our ON-LINE RENEWAL.

Go to click “Forms” and click “On-line membership renewal” link to “Acceptiva,” a secure server. A receipt is generatedand you do not have to submit this paper form.

Please complete all contact info. Print legibly! Current Credentials: LicensedOrdained

Name

Address

CityStateZip/Postal Code

CountryPhone

Cell PhoneE-Mail address

If married and both are members:

Name of spouse:E-mail: Cell #

May we text your cell phones concerning annual conference or membership renewals:  Yes  No

If you are working for/involved with a church or ministry please list:

Name of Ministry: ______Position:______

Address:______

Phone: ______E-mail:______Website:______

Newsletter:

 Yes, I would prefer to receive newsletter by e-mail

 No, I prefer to continue to receive the printed and mailed newsletter.

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For the purpose of accountability we trust you will understand our reason for the following questions. If you would feel free to answer accordingly, you can rest assuredthe information will be held within our strict standards of confidentiality.

Are you living a consistent Christian life according to biblical concepts?

 Yes  No

Do you strive to demonstrate in your daily life the fruit of the spirit (Gal. 5:22-23)?

 Yes  No

Do you handle your finances in private life and ministry with integrity according to biblical concepts?

 Yes  No

Has your marital status changed since the last renewal?

 Yes  NoIf yes, explain:

Submitting and signing this form indicates that the submitted information is truthful, and that you intend to do your best to be an active, supporting member of the Fellowship.You agree to servant leadership while demonstrating personal integrity, moral purity, financial responsibility and ethical standards of Christian conduct. Furthermore you agree that should you withdraw from the CFN FMC, fail to renew membership or have your membership removed for just cause, you will return your CFN FMC wallet-sized ID card, Membership Certificate and “Certificate of License To Preach” or “Certificate of Ordination” to the CFN FMC office within 30 days of request to do so.

Applicant’s Signature______Date____/____/____

Comments/suggestions:______

______

______

______

______

______

CREDIT CARD PAYMENT:

Card Type(circle): VISA MasterCard AMEX Name on card: ______

Card #:____ Exp. date:

Amount to be charged: $______(a $ 3.00 processing fee will be added) 3-digit V-code: ______Signature:

FOR OFFICE USE ONLY

Receipt and new card: _Date mailed: ______Database: Web directory: ______