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CHRISTIANS FOR BIBLICAL EQUALITY: membership
application form
Please print, complete, and mail or fax the following form to us.
All fees are in US dollars.
Name: _________________________________________________
Address 1: ______________________________________________
Address 2: ______________________________________________
City, St, Zip: ____________________________________________
Country: _______________________________________________
Email Address: __________________________________________
Home Phone: ___________________________________________
Work Phone: ____________________________________________
Website: _______________________________________________
Denomination: __________________________________________
Occupation: _____________________________________________
Birth date: ______/_______/________________________________
Marital Status: ___________________________________________
Please select your choice: (If the membership if for two
or more people, please pay the household rate)
United States resident:
Individual __ $120 for three years
__ $45 per year
Household __ $170 for three years
__ $65 per year
Low Income __ $25 per year*
E-Member __ $20 per year
Non-US resident (prices are in US dollars):
Individual __ $145 for three years
__ $55 per year
Household __ $190 for three years
__ $75 per year
Low Income __ $34 per year*
E-Member __ $20 per year
Additional gift:
____________ Total:
______________ Thank you!
CBE is an exempt organization as described
in IRC Sec. 501(c)3 and as such, donations in excess of the
basic membership fee may qualify as a charitable
contribution where allowed by law.
*You are eligible for the low
income CBE membership if your
combined household income is less than $23,000 a year.
If you are applying for this option,
please read the statement below and provide your signature:
I certify
that my combined household income is less than $23,000 a
year.
Signature: ______________________________________
Date: _________________
YES! Sign me up for automatic
membership renewals.
VISA
MASTERCARD
DISCOVER
AMERICAN EXPRESS
Credit card (13 or 16 digits):_________________________________________________
Exp. Date: _______________
Authorization Code: __________________
Authorized Signature (Cardholders Name):
________________________________________
Christians for Biblical Equality [CBE]
respects your privacy. Any personal information we collect
will be used only internally to minister to our customers
and members more effectively. Information regarding you,
including your name and address, will not be shared or sold
to any outside party.
2007MEMWEB
Please print and mail or fax the completed form, along with payment, to:
Christians for Biblical Equality
122 West Franklin Avenue, Suite 218 Minneapolis, MN 55404-2451
Phone: (612) 872-6898 Fax: (612) 872-6891
E-mail: cbe@cbeinternational.org
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