Associate Application Form

Title MrMrsRevDrOther

Name
Address


Post CodeTelephone Number
Email

Date of Birth [dd/mm/yyyy]
Marital Status: SingleEngagedMarriedDivorced
Have you ever been divorced? Yes No

Give brief details of your conversion [14 lines only]
Use a separate piece of paper if more space is needed.

Please answer relevant  questions:
1. Name of the church you are serving in

2. Name of the society you are serving in

3. Name of your Evangelistic Work


Why do you wish to be associated with the FEM? [10 lines only]
Use a separate piece of paper if more space is needed.

Do you accept without reservation the doctrinal statement of the Fellowship and its principles of separation from the Ecumenical and Charismatic Movements? Yes  No
Name and address of  the FEM member who recommended you . 
If referred by Living Word Bible Church Website please enter that as details.

Your Signature ______________________________Date

Enclose a subscription of £1.50 for every full month of the current year remaining.
Cheques payable to Fellowship of Evangelistic Ministries.
Amount Enclosed: £
This amount will be refunded if your application is not accepted.

Print and mail this form to:

Referred by Living Word Bible Church

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