Online Payment for New Affiliate Church Application

This Online Payment Form is offered as a convenience for individuals applying to join their church to the IMA and who would like to submit an online payment, rather than send a check or money order with their application.

Please be advised that your Online Payment will be processed immediately. Please do not submit an Online Payment until your District Chairman has approved your application and has sent it to the Home Office.

Your Name (must be completed by the IMA Member Pastor)

Church Name

Church Email

This address will receive a confirmation email

Church Phone

Church Address

Have you already sent a completed application to your District Chairman?

Yes No

Application Fee (Based on church attendance numbers)

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Online Payment for New Affiliate Church Application. Applications are held at the Home Office until payment has processed.

Online Payment for New Affiliate Church Application

Description

Please Fix the Following