Church Broadcaster Profile Setup – The Kingdom Christian Television Network

Church / Ministry Name:

Church Leader Name: *

First

Last

Church Leader's Title: *

Does the church have an IRS 501C3 number? *

If YES, please specify the 501C3 number below:

Church / Ministry Billing Address: *

Address Line 1

City

State

Zip Code

Senior Pastor's Direct Number:

Senior Pastor's Email: *

Church Customer ID (assigned by Kingdom CTVN) *

Church / Ministry Website:

Church / Ministry "Facebook" Page URL:

Church / Ministry "Twitter" Page URL:

Administrative/Delegated Point of Contact Person: *

First

Last

This should be the "go to" person that is assigned to respond to billing, administrative and/or initial inquiries in dealing with Kingdom CTVN.

Administrative Contact Person's Title/Role *

Administrative/Delegated Point of Contact Direct Number: *

Full Name of Video Producer/Technical Contact Person: *

First

Last

Video Producer/Technical Contact Person's Email: *

Video Producer/Technical Contact Person's Phone: *

Best / Direct Email Address: *

Email

Confirm Email