USA CHURCH APPLICATION     Today's Date  *   Church Name  * Mailing Address (Give street city state & zip)   Physical Address (Give street city state & zip)  * Pastors Name  * Office Phone with area code  * Home Phone Cell Phone   Email Address: Web site Is the Pastor affiliated with GMCI? YesNoApplied For If the pastor does not have credentials with GMCI nor has applied for them does he/she hold papers with some other group? YesNo   Secretary's Name and Phone  *   In what year was this church established?  * Is the church incorporated? YesNoIn the process   Approximate number of church members? 1-2526-5051-100101-150151-200201-250251-300301-350351-400401-500500   Do you keep Business Meeting minutes? YesNoNo but will begin immediately Does the church have an EIN? YesNoHave applied for one What is your EIN?  * Does the pastor or any staff member receive income from the church? YesNo   If yes are taxes withheld? YesNo Has the church been filing any kind of tax forms? State Yes or No. If Yes what kind of forms have been filed?  * Is the church applying for Legal Covering under our Group Ruling Exemption? YesNo   Has the church ever had a problem with the IRS or has the church ever been denied tax exemption status with the IRS? If yes give brief summary  *   Have you read and are you in agreement with our Statement of Faith? YesNoNot sure Is the church considered a Spirit Filled full gospel church? YesNoNot sure   Does the church operate a Day Care Nursery or School other than Sunday school? YesNo   Does the church have a Child Abuse Prevention Policy? YesNoNo but would like to have   Does the church have liability insurance? YesNoNo but in the process of applying for   Does the church or pastor have any Civil or Criminal Law Suites pending against it? YesNO If Yes give brief statement about the charges   How did you learn about GMCI?  *   Electronic Signature - By typing my name on this applicaton form I affirm that I am a legal representative of the church and authorized to sign this application for affiliation with GMCI. Give name and position  *   List officers or leadership of church   Pastor / Director  * Vice President / Associate  * Secretary  * Treasurer  *       Office Use Only Below This Line Date Received Dues / Amount Received Additional info needed Action taken Application approved Application Declined Comment Security code:   * Do not enter anything in this field: