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Application for Associate Membership

Type of Membership *

Individual (Application Fee is $25 Annually)

Group (Application Fee is $100 Annually)

Personal Information

First Name

Last Name

Email

Date of Birth

Phone

Current Community, Ministry, and/or Chaplaincy Involvement

Reason for Joining ICA

Reference

Name

Relationship

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Email

Agreement to Statement of Faith

I agree that I have read and agree to the Statement of Faith

Thanks for applying! We'll get back to you soon.

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Tel. 208-606-0307 I info@idahoca.org

1123 12th Avenue Rd #402 Nampa, ID 83686

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