Your contact information:
Full Name:	* required
E-mail Address:
Street Address:	* required
City & State:	* required
Zip Code:	* required
Daytime Number:	* required
Cell Phone Number:
Your interests:
Type of Credential Applying For:	Ordained Bishop Ordained Minister Licensed Minister Helps Minister
List 3 References along with Contact Info:
Information Section:
When did you accept Jesus Christ as your Savior?
Baptized in the Holy Spirit?	Yes No
Are you presently active in ministry?:	Yes No
If so, what kind of ministry are you currently involved in?
Do you presently have any ministry credentials?	Yes No
If so, who are you currently credentialed with?
Education Level Completed	High School (Current) High School GED Associate Bachelors Masters Doctorate Other
Payment:
Your application for credentials will not be processed until this application has been submitted and payment has been made.  If you would like to pay online, you will find a payment option located on the right hand side of this page.  ($150 for Individual Credential, $200 for Married Couple Credentials)
Statement:
I hereby state that all the information contained in this application is correct and true to the best of my knowledge.   I understand that all items related to this application submitted to MII are part of the application process and become the permanent property of MII and will not be returned to me.