Membership Application

1. Name of Organization:*
2. Type of Organization:*National Association DenominationAgencyAssociateOther
3. Mailing Address:*
4. Telephone:*
Fax:
5. Email:*
Website:

6. Number of Caribbean Islands/Countries organization is located?

7. Number of Congregations/Member Bodies/Branches in organization?

8. Is Organization Registered?*
YesNo
[group group-1]
Registration Date:
[/group]

9. Is Organization Incorporated?*
YesNo
[group group-2]
Incorporation Date:
[/group]

10. Has the Governing Body of the Organization agreed to become a member with the Evangelical Association of the Caribbean?*
YesNo
11. Is the Organization in agreement with EAC’s Statement of Faith?*
YesNo
[group group-4]
I read and agree with the Statement of Faith.
[/group]

12. Is the Organization in agreement with the Constitution of EAC?*
YesNo
13. Is your Organization prepared to subscribe to all the provisions of EAC?*
YesNo
14. Why do you wish your organization to become a member of the EAC?*

15. President of Organization:*
16. Mailing Address:*
17. Telephone:*
Email:*

18. Secretary of Organization:
19. Mailing Address:
Telephone:
Email:

20. Treasurer of Organization:
21. Mailing Address:
Telephone:
Email:

22. Names and addresses of two references:*
22.1
22.2

23. Membership categories and fees in United States of America Dollars (US $): $350.00 National Association; $275.00 Denomination; $175.00 Agency; $100.00 Associate Please submit appropriate fees with application.

24. Will your Organization commit to pay this fee by January 31 of each year?*
YesNo

PLEASE ATTACH THE FOLLOWING WITH YOUR APPLICATION
Constitution & Bylaws of Organization*

Copy of Incorporation or Registration*

Membership Fee Payment Receipt*

Please leave this field empty.

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