Affiliate Application


Congregational Member Affiliate Application

“This level of participation in the Harvest Network community is for members of local churches who desire to be directly informed of Harvest Network sponsored events and have access to Harvest Network’s resources.”

Please complete the application in its entirety, accompanied by the following items:

  • Endorsement by a Pastor (have your pastor email us at
  • Annual Dues: $48 (after submitting the form, must sign up for an automatic payment plan of $4/month).

Individual Information

Applicant Name *
First Name
Last Name
Cell Phone
Home Phone
Address *
Address Line 1
Address Line 2
Postal Code
Date of Birth*
How did you find out about the Harvest Network?

Church Information

Church Name*
Your Pastor*
Pastor's Email (if known)
Please select the status of your Pastor's Reference: *
I certify I will complete the online payment after submitting this form (instructions available after submitting). *



This level of membership does not include licensing. Please contact with any questions.