MAP Affiliate Registration - Southern Seminary

Please read the MAP Affiliate Agreement. *

MAP Affiliate Registration

Church/Parachurch Contact Information
Church/Parachurch Name*
Address*

Street Address
Address Line 2
City*
State/Province/Region*
Postal/Zip Code*
Country*
MAP Instructor/Supervisor Information
MAP Supervisor Name*
MAP Supervisor Title*
Email*
Highest Degree Earned
MAP Supervisor Phone Number
*
- I have read and agree with the MAP Affiliate Consent Form.