Name of Ministry*
Address*
City, State, Zip*
Business Phone*
Secondary Phone*
Principal Officer*
Email Address*
Date of Incorporation*
Reasons for desiring membership in Network 220.*
Briefly describe the general functions of your ministry.*
Briefly describe the general focus of your ministry.*
Please list the members of your Board of Directors*
Please list the members of your Ministry Staff.*
What type of legal entity is your ministry?*
Does your ministry possess an I.R.S. determination letter? *
Yes
No
Have you carefully read the Network 220 Doctrinal Statement on our website? *
Yes
No
Do you agree 100% with every point in the Network 220 Doctrinal Statement? *
Yes
No
If you do not agree with any point(s), please identify each and explain.
Do you agree to submit the $100 application fee either by mail or via our website? *
Yes
No
Signature (Type Your Name) *
Today's Date *
Name of your sponsor? (Must be someone who already belongs to Network 220.) *
Do you agree to contact your sponsor and be responsible for asking them to submit the Sponsor Form? *
Yes
No
What ministry contact information (name, address, phone, email, website) would you like us to publicly display? *
SUBMIT
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