Contact Information

By filling out this web form, you are applying for a partnership with NCLL for your ministry.  Credit card information will be requested at the bottom of the form.

 

Ministry Name*

Please enter the Senior Pastor or Ministry Leader's title, name and email address, as well as the ministry's mailing address and phone number below.

 
Title (Pastor, Dr., Mr., Mrs.)
First Name*
Last Name*
Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Ministry Email*
Confirm Ministry Email*
Ministry Phone*

Partnership Choices

 

Premier Partnership Yearly ($1,000.00)

  - This option is for the Primary ministry that wants to make their partnership donation one-time for the year.

 

Premier Partnership Monthly ($100.00)

 - This option is for the Primary ministry that wants to make their partnership donation once monthly for the year.

 

Supporting Ministry Partnership Monthly ($20.00-$95.00)

 - This option is for the Primary ministry that would like to donate at less that $100/month.


Premier Affiliate Partnership Yearly ($500.00)

 - This option is for a secondary ministry of the primary ministry (like a school or camp) that wants to make their partnership donation one-time for the year.

 

Premier Affiliate Partnership Monthly ($50.00)

 - This option is for a secondary ministry of the primary ministry (like a school or camp) that wants to make their partnership donation once monthly for the year.

 
 
 
Partnership Level*
  • Premier Partnership - Yearly
  • Premier Partnership - Monthly
  • Supporting Ministry Partnership
  • Premier Affiliate Ministry Partnership - Yearly
  • Premier Affiliate Ministry Partnership - Monthly

Donation Options

Donation Amount*
$

Payment Options

Amount*
$
Name on Card*
Card Number*

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