Complete Transaction v2

Date of transaction*

First Name*

Last Name*

Street Address*

Address Line 2

City*

State-Province-Region*

Zip Code*

Email used in transaction*

Mobile Phone Number*

Home phone number*

Fill out this section for New Memberships Only

Annual Conference

Membership Region

Most Recent Year Ordained, Commissioned or Licensed

I am Applying For (US)

My Ordination Status

My WCA Membership Status

Are you willing to be listed in a directory on the WCA website?YesNo

Church Name

Street Address

Address Line 2

City

State-Province-Region

Zip Code

Fill out this section for Membership Renewals Only

Have you moved since your last membership application?NoYes

Do you attend a new church since your last registration?NoYes

If yes, complete section

Street Address

Address Line 2

City

State-Province-Region

Zip Code

If yes, complete section

Church Name

Street Address

Address Line 2

City

State-Province-Region

Zip Code