Church Charter Member Application

All fields are required | Please use N/A as necessary

Church Name*
Church Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Additional Campus or Properties*
Please list any additional property owned that is accessible by minors.
Senior or Lead Pastor's Name*
First Last
Senior or Lead Pastor's Email Address*
Senior or Lead Pastor's Phone Number*
List Board Structure, Names, and Contact Information*
Applicant Name / Primary Contact*
Child Safety Coordinator's Name*
First Last
Child Safety Coordinator's Email Address*
Child Safety Coordinator's Phone Number*
Church ECAP Council Representative Name*
First Last
Church ECAP Council Representative's Email Address*
Church ECAP Council Representative's Phone Number*
Denominational / or Network Affiliation(s)*
Denominational Contact*
Year Founded*
Weekly Attendance*
Membership Total*
Number of Children and Youth*
Number of Children and Youth Staff and Volunteers*
Allegations of Abuse*
Describe general information, date of the incident, and date of resolution. Please exclude names and confidential information.
Financial Overview*
Include general funding sources and specify any sources of funding from children or youth programs.
Outside organizations or programming that Utilize Campus Facilities (threats & liabilities)*
List outside organizations or programming that utilize your campus and serve minors.
Insurance Carrier*
Please Confirm the Following*
- Our governing board has sent a letter to ECAP initiating our candidacy status
- We affirm the ECAP statement of faith
- We have signed the Charter Member MOU

Accreditation - Church Contact

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"*" indicates required fields

Reason for Contact*

Name*

First Last

Email*

Phone*

Organization Name*

Tell us about your Accreditation question

Primary Location*

Street Address City State / Province / Region ZIP / Postal Code

Website*

Type of Ministry*

Select all that apply

Church

School

Camp

Other

Number of Subsidiary Entities*

This is any additional ministries you operate

Number of Campuses*

The ministry campuses/locations within your legal entity.
Include the locations of any additional ministries you operate.

Number of Participants

Leave blank if not applicable.

Church

Average weekly total attendance at your campuses, including adults and minors.

School

Total annual enrollment in the past full academic year.

Camp

Average annual number of minor participants, based on the past two years.

Other

Annual number of minor participants, based on the past two years.

Denomination or Network Affiliation (If any)*

Head of Ministry Name and Title*

Church Charter Member Application

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