Membership Application

Highways and Hedges Ministry, Inc.

Instructions: Please print clearly. Be sure to fill in all blanks and check all boxes.
Please include all references.

Application Date: ______________________________

Name: ________________________________________________________________

Name of spouse (if co-applicant): _________________________________________

Street Address: ________________________________________________________
City: ________________________________State: ___________Zip: _____________
Email: ___________________________________________
Home Phone: (____)_______________Cell Phone: (____)______________________

Home Church: _________________________________________________________
How long you have attended: __________________________________
Pastor’s Name: ________________________________________________________
Home Phone: (____)__________________Church Phone: (____)________________

Character Reference #1 (Name): __________________________________________
Relationship: Friend Family Member
Years Known: ________________
Home Phone: (____)___________________Cell Phone: (____)__________________

Character Reference #2 (Name): __________________________________________
Relationship: Friend Family Member
Years Known: ________________
Home Phone: (____)___________________Cell Phone: (____)__________________

To be filled out by your pastor or church leader. Dear Pastor,
Highways and Hedges Ministry is accepting for membership, Christian men and
women who are mature in their faith, faithful to their local church and ready for
ministry. What can you tell us about this applicant? (Include spouse if applicable).
Attach additional sheet if necessary.

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(Continued on back)

To be filled out by the applicant. Dear applicant, in just a few sentences, tell us
what Jesus Christ means to you today.

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

To be filled out by spouse (co-applicant). Dear co-applicant, in just a few
sentences, tell us what Jesus Christ means to you today.

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

If you have not read a copy of the H&HM Guidelines and mission statement
please do so before continuing.

1. I have read the H&HM Guidelines. I understand and support them. Yes No
2. I have read the Mission Statement. I understand and agree with it. Yes No
3. I understand that H&HM is a ministry, not a club or riding organization. Yes No
4. I understand that the center patch I will receive is not mine and will be
willingly returned should I ever leave this ministry for any reason. Yes No

Applicant’s Signature: __________________________________________________

Date: _________________________

Spouse’s Signature (if co-applicant): ______________________________________

Date: _________________________

Authorized Signature: ___________________________________________________

Date: _________________________ (Any H&HM National Director).

Mail completed application to:
Highways and Hedges Ministry, Inc.
PO Box 326
Alexander, AR 72002
If you have any questions please call: (501) 804-1929

Please allow approximately two weeks for processing of the application.