Name of Ministry or School
First Name
Last Name
Middle Initial
Street Address
City, State, Postal Code
Date of Birth
Social Security Number or Tax ID Number
Home Phone Number
Office Phone Number
Fax Number
Website Address
eMail Address
Please list all school, colleges, universities or seminaries attended
Please list three ministry or clergy references with contact information

Do you agree with our doctrinal statement?
Yes No

Will you comply with our Code of Ethics?
Yes No

The following questions have no bearing on your membership approval or denial.
Will you financially support the WCICC Mission programs?
Yes No

Do you understand and agree with the financial obligations of WCICC Membership?
Yes No



After you complete the application you will be directed to the secure WCICC payment page. You can make a payment from any of the above countries using your JBC, Visa, Master Card, American Express or Discover Card. We accept both Credit Cards and Debit Cards. You may also make payment via on line Check using your Checking or Savings Account. When asked enter your credit card, debit card or Checking or Savings banking information. Again this is a safe secure server and billing option with CCBill.

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For more information feel free to Contact Us