International Institute of Church Management
Affiliated and a Branch of International Institute of Church Management Inc., Florida, USA
Affiliated with International Institute of Church Management Inc., Pennsylvania, USA
Accredited by AAATI- American Accrediting Association of Theological Institutions, NC, USA
A Certified Member of ACEA-Apostolic Council of Educational Accountability, CO, USA
A Certified Member of NATA- National Association for Theological Accreditation INDIA

Founder/President: Dr. John Williams
Office:  240, Ruby Tower,  Velachery Road, Selaiyur, Chennai – 600 073.
Tel # 22395346/22791970                       Email: website@iicmet.org
Web Site: http://www.iicmindia.org
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APPLICATION FORM FOR AFFILIATION

 1. NAME OF THE FOUNDER / PRESIDENT                :

 2. FULL ADDRESS                                                    :

3. TELEPHONE NO. OFFICE  :                                              RESIDENCE  :

                                     EMAIL  :                                              WEBSITE      : 

4. NAME OF THE CHURCH / INSTITUTION WHICH SEEKS AFFILIATION                             : 

5. LOCATION AND MEMBERSHIP OF EACH OF THE CHURCH OR INSTITUTION               : 

 5. NUMBER OF PERSONS WORKING IN YOUR CHURCH OR INSTITUTION : PASTORS _________   FULL TIME WORKERS_______

 6. DATE OF ESTABLISHMENT OF MAIN CHURCH OR INSTITUTION    :

 7. CURRENT TOTAL                                                    : MEMBERSHIP___________ 

                                                                                   : STAFF_________________ 

8. REASONS FOR SEEKING AFFILIATION                    :

 9. CHANGE OF NAME

a)      WOULD YOU LIKE TO RETAIN THE SAME NAME WITHOUT ANY CHANGE : ______________

 b)     WOULD LIKE TO RETAIN THE SAME NAME BUT WOULD LIKE TO ADD AS FOLLOWS : ______________

“AFFILIATED WITH INTERNATIONAL INSTITUTE OF CHURCH MANAGEMENT”

 10. THE VISION, AIM, OBJECTIVE AND ANNUAL REPORT OF YOUR INSTITUTION :
       (ENCLOSE SEPARATELY)

11. ANY OTHER INFORMATION THAT YOU WOULD LIKE TO ADD  :

DATE:______________                                                               SIGNATURE:__________________