Foreign Affiliation Application - AEGA Ministries International, Inc.

Church/Ministry Name*

Church Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Church/Ministry Phone*

Church/Ministry Fax

Email*

Full Name of Pastor/Director*

Residence Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Residence Phone

Pastor/Director Date Of Birth:

Present Status

If other, explain:

If you are applying to affiliate a church, how often do you meet for services?*

How long has the church been established?*

How many members do you have?*

What types of ministries do you have in the church?

If other, explain:

If you are applying to affiliate a ministry, what type of ministry do you perform?

If other, explain:

SPECIAL NOTE: (Stipulations)
1) The affiliating organization is NOT PERMITTED to use the AEGA name or logo on any of its literature or advertising (unless specific written permission is granted by the AEGA Headquarters).
2) The report of any action on the part of this organization which is not glorifying to the name of Jesus Christ shall be investigated and may result in the voiding of this affiliation.

I attest that the above information is true and accurate to the best of my knowledge, and I have read, understood and agree to the above stated stipulations.*

Signature of Pastor/Director: (type your name)*

Date:*

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