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Patria Membership Application

Membership in Patria is based upon relationship and not upon completion of paperwork.  This application is designed to gather the basic information needed in order to begin developing relationship.  This same form can be used by both organizational and individual applicants.  The designated representative of any organization should complete the personal information section.   

Select an option

Individual applicants please complete this section

To which of the following categories do you belong? (Check all that apply)
Does your ministry have recognized 501(c)(3) status?

Please provide a personal reference from one or more of the following choices (mark all that you will have sent, however if you have a home church one reference from your church is requested).  Your reference should include an endorsement of your personal character and integrity. References may be emailed to or uploaded below:

Select all that apply
Upload File
Upload File
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