Date (required)

Your Name (required)

1. Continuing Education
Tell us about your professional development over the past year (training, seminars, webinars, workshops,
etc.). You can be very brief.

2. Consultation Work
What churches have you consulted over the past 12 months? Please provide church name(s), locations, date, and a brief summary of the results of each engagement.

3. Published Writing
Please provide any links to articles or the names of books you’ve published in the past 12 months.

4. Frameable certificate. Do you want us to email you an updated one for your renewal?:

YesNo

5. Directory Information Updates
Directory info is at the location on our website: https://churchconsulting.org/search-consultants/
Please help us keep our records up to date by updating any information below.

6. Certification Renewal Fee: $238
To pay your Renewal Fee, we offer you 4 different payment options:

1. You can pay online here: https://churchconsulting.org/?p=6858

OR,

2. Email mark@churchconsulting.org or call him at 763.744.7338 with the following information:

Name on the card:
Type of Card (MC, VISA)
Complete billing address on the card:
Card#:
Expiration Date of Card:

OR,

3. You can mail a check made out to Society for Church Consulting to our address at: 6771 21st Ave. S. Lino Lakes, MN 55038

OR,

4. If you prefer to convert to a monthly payment plan where we draw an electronic transfer from your
bank account or credit care, email our bookkeeper dorothy@churchconsulting.org and
she will help you set that up.

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