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Description & Fees Application/Waiver Release Certification Endorsement FOR MEMBERS ONLY

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List of Names Regions Map (Click on) Reg. VP's Pacific Region Mountains & Plains Region Great Lakes Region Southern Region Northeast Region

Letter from the Presidents FCM History

Membership Renewal & Annual Report

Please apply for FCM membership renewal by one of the following 2 ways:

1. Send in the application form (Download the PDF here)

2. Fill out the online application form below.

Dues payments are for 2010 - Report Period - January 1st. through December 15th 2009
To remain a member in good standing all dues and annual reports must be submitted no later than December 15, 2009

PLEASE PAY VIA THE ONLINE PAYMENTS DROP-DOWN OR (CLICK THE "ADD TO CART" BUTTON)
BEFORE COMPLETING THE ONLINE FORM BELOW

Non-certified member dues: $50.00
Certified member, dues and certification renewal fee: $150.00
Professional Endorsed Membership, dues & fees: $210.00
Please follow these directions: 1. Please pay for your membership BEFORE you complete the form by clicking on the "add to cart" button or going to the dropdown, ONLINE PAYMENTS. Be sure to copy down your paypal receipt number, you will need it to complete your renewal form. After you have made your payment return to the Renewal form. 2. Complete your renewal form. Put your Receipt number in the appropriate box. Enter the text from the image and press submit. Your Done!

Please select which type of member you are:

Name:

Address:

City:

State, Province or Region:

Zip Code:

Country:

Home phone number:

Work phone number:

Email:

If you would like to serve on a standing committee, please select which one:

My ministry includes:

Describe your ministry and your participation within the FCM community during the past year:

I have updated my skills in ministry this past year by:

Certified members are required to have a ministry colleague. Please tell us who your ministry colleague is
and when you last met:

All members please read, sign and date the following: It is the position of FCM that each member of FCM holds primary responsibility for maintaining appropriate professional and personal boundaries in all ministerial relationships. Within the past year, have you been convicted of a felony, or have you had any disciplinary action taken against you, or are any such actions pending by any licensing and/or certifying authority?

If you answered yes, please download the PDF of the form to fill out your renewal and send it with your dues payment to the Central Office

I have read the Constitution/By Laws, Ethics Statement and Professional Practices Policy of the Federation of Christian Ministries and agree to abide by the conditions specified in these documents:

Date:

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