Wufoo

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Renewal New/First Time Member
Dues Payments: NCMA membership is for the calendar year
Full-Time Staff = $90.00 Part-Time Staff = $60.00 Students = $25.00 Institutional = $120.00 Retired and All other Non-Students = $45.00
Form of Payment (Paypal, Personal Check, Institutional Check (with check#) *

Institutional membership includes one vote per institution. Any number of that institution's staff may attend NCMA conferences at the member rate.

Please note that NCMA does not permit its membership information to be distributed or used for any purpose other than by the National Campus Ministry Association and its specified officers. It is not sold or provided to outside sources.
Name * First Last
Phone Number * ### - ### - ####
Ministry/Office Email Address (If different from above) *
Name of Ministry You Serve
Ministry Mailing Address (If different from above) *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Ministry Website Address
Name of Academic Institutions Served by You & Your Ministry(Including campus sites)
With which Denomination(s) is your ministry affiliated?
Your Personal Denominational Affiliation
What best describes the context of your ministry's operation
Check all that apply to you:
Clergy Lay Person Third Choice Full Time Student Part Time Student Volunteer Faculty Ministry Board Member Intern Retired Sustaining(Campus Ministry Friend) Other
How many years in Collegiate Ministry?
If interested in the mentorship program please select one of the following options.
I would like to be a mentor I would like to be matched with a mentor
$______ I have added my donation to the membership dues assistance fund. *

Once you've filled out this form please submit payment via paypal or check or money order to the address given on our home page. Thank you.
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