Name Of Applicant
Mailing Address:
Email Address:
What Do You Do In The Gospel Industry?
Telephone Contact:
Are You Affiliated With Any Of The Enlisted States?
City/State/Zip Code:
What State Are You Representing?
Which Membership Are You Paying
(First)
(Last)
Alternative Contact:
Arkansas/Tennessee ~ Florida ~ Virginia ~ Oregon ~ North Carolina
Membership Application
A
P
P
L
I
C
A
T
I
O
N
N
I
G
M
A
Method Of Payment
Expiration Date:
Month
Year
Alabama
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Lousianna
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Nevada
New Hampshire
New York
North Carolina
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Local ($75)
National ($75)
Local & National ($85)
Minister Of Music
Director
Comedian
Musician
Gospel Artist
Liturgical Dance/Mime
Radio Announcer
Promoter/Media
Pastor/Minister
Motivational Speaker
Other
Yes
No
Visa
MasterCard
Discover
American Express
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2024
2025
2026
2027
2028
2029
2030
2031
2032