Name(Required) First Last Email(Required) Enter Email Confirm Email Phone(Required)Are you already a Church Benefits Board participant in retirement and/or Group Life, LTD, and AD&D insurance?(Required) Yes No How would you describe yourself?(Required) Soon-to-be or recent seminary graduate Changing careers and about to serve your first church Are you full-time at your "first-call" church?(Required) Yes No What is your title?(Required) When did you begin your first full-time ministry position?(Required) Month Day Year Church/Employer(Required) Employer Address(Required) City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Additional information/comments:PhoneThis field is for validation purposes and should be left unchanged.
