Church Information Form

Please complete the form below

"*" indicates required fields

Legal Name of Church*

Known / Common Name of Church if different than above

Lead Pastor*

First Last

Church Employer Identification Number (EIN)*

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Mailing Address is ...*

Physical Church Address where services are held*

Street Address Address Line 2 City State ZIP Code

Church Phone #*

Church Website

Church Email*

Please list other pastors of your church

Please upload the church's proof of insurance

Max. file size: 100 MB.