Regional Staff Authorization Form

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Regional Staff Authorization Form

For regional staff seeking authorization to complete any ministerial credentialing and clergy authorization forms, please complete the short form below.

First Name *

Last Name *

E-mail Address *

Phone Number (Office) *

State *

Region * General Commission on Ministry (GCOM)Christian Church in Alabama and Northwest FloridaChristian Church in ArizonaChristian Church of Northern California-NevadaChristian Church of the Pacific SouthwestChristian Church in CanadaCentral Rocky Mountain RegionChristian Church in FloridaChristian Church in GeorgiaThe Great River RegionChristian Church South IdahoChristian Church in Illinois and WisconsinChristian Church in IndianaChristian Church in the Upper MidwestChristian Church in KansasChristian Church of Greater Kansas CityChristian Church in KentuckyChristian Church MichiganChristian Church of Mid-AmericaChristian Church in MontanaChristian Church in NebraskaChristian Church - Northeastern RegionChristian Church in North CarolinaChristian Church in OhioChristian Church in OklahomaChristian Church in OregonChristian Church in PennsylvaniaChristian Church in South CarolinaChristian Church in TennesseeChristian Church in the SouthwestThe Christian Church in VirginiaThe Northwest Regional Christian ChurchChristian Church Capital AreaChristian Church in West Virginia

Regional Job Title *

Your preferred user name *

If you are human, leave this field blank.

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Upon submitting this form, you will receive within one business day notification of your Membership ID. If you have not heard from Search and Call staff within one business day, please contact Anne Marie Moyars at (317)713-2664.

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