ALMA Membership Application Form

Please enter the information below. (required fields are marked with a *)

*Mission Agency Name:

(Agency Name should be exactly as you want it to appear on the Web site. Forty (40) characters maximum)

*Mission Agency Address:

Additional Address:

*Mission Agency City:

*Mission Agency State:

(Select "Other" if not United States)

*Mission Agency Zip Code:

Country:

(Enter if not United States)

*Mission Agency Phone:

Mission Agency Fax:

*Mission Agency Email Address:

Mission Agency Web URL:

http://

Check if agency is RSO:

RSO Affiliation:

Speciality Area:
Please chedk all boxes that apply to your mission agency.

Children/Youth	Cross-cultural Church Planting	Human Care
Leadership Development	Literature, Bible translation, Literacy, Mass Media	People/Affinity group
Short-term opportunities, resources; training

World Locations:
Please check all boxes that apply to your mission agency.

Africa	Asia - East, South & China	Asia - Central & Middle East
Carribean, Central America, Mexico	Europe - Russia	North America
South America

Primary Contact Person (required fields are marked with a *)

*)Title:

*First Name:

*Last Name:

*Address:

Additional Address:

*City:

*State:

(Select "Other" if not United States)

*Zip:

Country:

(Enter if not United States)

*Phone Number:

Fax Number:

Email Address:

Secondary Contact Person

Salutation:

First Name:

Last Name:

Address:

Additional Address:

City:

State:

(Select "Other" if not United States)

Zip:

Country:

(Enter if not United States)

Phone Number:

Fax Number:

Email Address:

*A description of your Mission Agency's Ministry (Mission Statement, what you do, etc.):

Enter a username and password that you will use to access your membership information. Write this information down and keep it in a safe place.
NOTE: It is the Mission Agency's responsiblity to keep your information current. Once your mission agency is accepted as an ALMA member you will be given the opportunity to add additional information about your mission work to your profile that will be viewable on the ALMA Web site.

*Username:

(Username can only be letters or numbers no spaces.)

*Password:

(Password can only be letters or numbers no spaces.)

*Confirm Password:

Please carefully check over your entries and when satisfied they are correct, click on the "Apply" button only once!

NOTE: Depending on the speed of your Internet connection, it may take from a few seconds to several minutes for your application to be processed by our server.
When the server is finished processing your information
you WILL be taken to the next page.