New Supervising Member Registration 2009-2010

1. Name

First

Last

2. Ministry Name

3. Your Title

4. Mailing Address

5. Email Address

6. Organizational Web Site Address

7. Phone Numbers

Office
Home
Cell

Prior to approval, I understand that I must provide the following:

- Ordination documentation (must have minimum of 5 years of full-time ministry).
- Letter of Appointment from the sponsoring body of your ministry indicating that you are the official representative of the religion/faith/denomination.
- Copy of diploma or proof of two years of formal education beyond the undergraduate level.

` Please send the three materials above to:

Dr. Tom Burke, CMA Liaison
Associate Vice President for Student Affairs
201 Holmes Hunter Academic Building
The University of Georgia
Athens, GA 30622

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