Mbmaa Membership Form

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Mississippi Baptist Ministry Assistants Association

Membership Application and Information Sheet


New Membership____ Renewal____ for the Year: April 1, 2015 March 31, 2016

Personal:
Name: (Miss, Mrs., Ms.)__________________________________________________________________
Place of Employment:____________________________________________________________________
Postion:_______________________________________________________________________________
Supervisors Name:______________________________________________________________________
Office Address:_________________________________________________________________________
City:__________________________ State:________________ Zip:______________________________
Telephone: ___________________ Fax:_____________________ E-mail:_________________________
Home Address:_________________________________________________________________________
City:__________________________ State:_________________ Zip:_____________________________
Home Telephone:_________________________ Cell Number:__________________________________
Church Membership:_____________________________________________________________________
Special Talents:_________________________________________________________________________

Area of Ministry:
List Positions you have held in church, association, and /or denomination:
______________________________________________________________________________________
______________________________________________________________________________________
List conferences you have led or taught:
______________________________________________________________________________________
______________________________________________________________________________________

Certifications: (Check the courses you have taken)


Professional Certification (Basic)____________ Skill Shops (Advanced)________________

Service in MBMAA: (List position or office held)


______________________________________________________________________________________
Would you be willing to serve as an officer and/or on a committee in MBMAA?_______________

Signature:______________________________________________________________
Please make $ 15.00 check payable to: MBMAA
Mail dues to: Amy Massey
c/o MBCB Baptist Record
PO Box 530
Jackson, MS 39205
Please remember to include this form with your check.

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