Company of Prophets Musicians Fellowship International

Membership Application

Please include all information you wish to be reviewed for your membership consideration.  Please attach additional sheets if necessary.  Your information is confidential and will be reviewed solely for the purpose of membership.

Date of Application:  _____________________         Fee:  $150/ year

Name:                                                                                                        

                                Last                                        First                                         Middle                     Jr/Sr/III/Esq/Ph.D

Date of Birth:          /                  /               Marital Status:                                 

                                           mm           dd               yyyy

Spouse name:                                    Anniversary date:          /        /       

Address:                                                                                                    

                                Street                                                                       Apt# or Unit

                                City                                                          State                                                         Zip

Phone No:   Home:(        )                                Cell:(         )                        

                                                  Area Code                                                                   Area Code

                   Fax:(         )                                   Other:(         )                     

                                              Area Code                                                                            Area Code                     

Email address:                                  Website:                                           

Church Name:                                                      Phone:(       )                 

Church Address:                                                                                        

                                                City                                                          State                                               Zip

Church Website:                                         Email:                                     

Pastor’s Name:                                                                                          

Your Position(s):                                                                                       

Questionnaire:

1)  Where do you prefer to receive your mail?    ____home      ___church

2)  Are you in full-time ministry?  ____Y   ____N      If no, where are you employed? 

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3)  Are you a Pastor?  ___Y ___N    If so, name of church: ______________

_____________________________________________________________

4)  Are you a Minister of Music? ___Y ___N    If so, where? ____________

_____________________________________________________________

5)  Are you a licensed _____  and/or ordained ____ minister?   ___Y ___N

Date of Ordination: _____________   Date of Licensure: __________

6)  Are you a church musician?  ___Y ___N     Do you also play other venues?    _____Y   ____N

7) What instruments do you play?  _________________________________

8) What is your primary instrument?  _______________________________

9) Are you born again?  ___Y  ___N      Since when: _______________

10) Are you a tither?  ___Y ___N

LIST 3 CHARACTER REFERENCES:

1) Full name:                                                                                             

   Address:                                                                                                 

                                         Street                                                       Apt# or Unit

   ____________________________________________________________

                                                City                                                          State                                         Zip

2) Full name:                                                                                             

   Address:                                                                                                 

                                         Street                                                       Apt# or Unit

   ____________________________________________________________

                                                City                                                          State                                         Zip

3) Full name:                                                                                             

   Address:                                                                                                 

                                         Street                                                       Apt# or Unit

   ____________________________________________________________

                                                City                                                          State                                         Zip

Any additional comments: _______________________________________

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                                                                             Thank you.