International Clergy Association

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INTERNATIONAL CLERGY ASSOCIATION MINISTERS APPLICATION FORM

Please be sure to complete this application form in its entirety. Remember to enclose 2 passport sized photos of yourself (do not staple). Be sure to enclose your annual application/Credential fee in the proper amount (GH 30). Upon receipt, the General Board will review your application, and if approved, you will be notified via email and mail.

Section 1: Personal Information

First Name:
M1:
Last Name
Age
D.O.B
Sex
Marital Status
SSN
Spouse’s Name
Spouse’s Age
Date Of Birth
Mailing Address
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State
Zip Code
Country
Home Phone
Physical Address
Apt.
City
State
Zip Code
Country
Email
Alternate Phone

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