B.S.C.L.N. Membership Form

Become a Member of the Bivocational & Smaller Church Leadership Network
2010 B.S.C.L.N. MEMBERSHIP INFORMATION FORM

Annual Fees: *

		- $ 00 - Information ONLY
		- $ 25 - Minister
		- $ 10 - Spouse
		- $100 - Supporting Church / State
		- $100 - One in a Thousand Club

Payment Choice:

Pay-Pal on Membership Page

Personal Check via Mail

Total amount to be mailed: $

This form is for membership information.
Membership fees may be paid via PayPal at the Membership Page of BSCLN Web Site at: www.bivosmallchurch.net
* If paying by "Pay Pal" send Payment to: joyce.byrd@belmont.edu
Membership fees may be paid via personal check if mailed to Joyce Byrd (addressed listed in box below)
Notice: Membership begins when membership fees are received

Full Name: *

Spouse Full Name:

Home Address:

City:

State:

Zip:

Home Phone:

Cell Phone:

E-Mail:

Your Birthdate:

mm/dd/yyyy

Spouse Birthdate:

mm/dd/yyyy

Wedding Anniversay:

mm/dd/yyyy

Church Name:

Church Address:

City:

State:

Zip:

Church Phone:

E-Mail:

Check Ministry: *

Mail Checks to:
Joyce Byrd
5111 Marc Ct.
Nashville, Tn. 37211

joyce.byrd@belmont.edu

Membership Benefits Include:

Quarterly Newsletter
Information about educational opportunities
Leadership Training
Regional Conferences
Regional Resource Ctn.
Network w/ other Bivo's
Affirmation & encouragement
Professional & Personal Growth Opportunities
www.bivosmallchurch.net

* = Input is required