Title/Name *

Date of birth

Spouse's Title/Name *

Spouse Date of Birth

Address

City

State

Postal code

Ministry or Non- profit Information

Ministry at $150 per month and $100 per month for Non-profits.

Ministry Name

Ministry Address

Ministry Website

Ministry Phone Number

Why do you want to be apart of PIF and what do you expect to recieve?

Method of Payment

Collect Payment *

$ 100

$ 150

$ 250

Other amount

I confirm that I want to receive messages from using the contact information provided.

First Name