Membership Enrollment Form

A business membership costs $425 and allows two individual members to log in to the website and receive electronic mailings, in addition to the business benefits your organization receives. Additional members can be added for $80 per person.

The enrollment process requires an executive director contact, who is the president or main contact of your organization, and a billing contact, who can be the same person or someone else responsible for keeping your profile updated and for annually renewing your membership.

Be sure to update your Members screen with the two people who should receive member benefits.

You will be able to review your information and make changes at the end of this process. Do not press the “Back” button or you will lose the information you’ve entered.

New Enrollment

*Organization Name
Membership Type	Business
*Address
Address 2
	Start typing your city and select from the options that appear to autofill your city and country.
*City
*State
*Country
*Zip
*Phone	(xxx-xxx-xxxx)
Fax
Toll Free Number
Website
Email
Description	Use this area for a brief description of your business.
Opt Out Directory	Exclude from Organization Directory
Latitude	Find my coordinates
Longitude
Business Type

North America's oldest and largest network of independent faith-based crisis shelters and rehabilitation centers offering radical hospitality in Jesus' name.

Member Spotlight

Membership Enrollment Form