Welcome to Church Plant Media, we're excited about our continued partnership!
Please review these items carefully before getting started:

Gospel Agreement: www.churchplantmedia.com/gospel
Radius Protection: www.churchplantmedia.com/design-style-availability
Service Agreement/Terms: http://www.churchplantmedia.com/service-agreement-terms

Note: This form needs to only be filled out by our current partners who desire to either upgrade their website or purchase an additional site. If you're a brand new partner, please go to www.churchplantmedia.com/new-partner to get started.
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Which type of partner are you? *


 
Will this new site be: *


 
What's the name of your current site with Church Plant Media? *

Please make sure to write it as it is in the Content Management System, including not only the name but also the location (e.g. Example Church: City, State).
 
Great! Tell us a little more...

 
What is the name of your {{answer_3147503}} ?

 
What denomination, affiliation, or group are you associated with? *

 
What is the office phone number?

 
Does your {{answer_3147503}} have a physical location? *


 
What is the address? *

This is the address that we will protect so no other church or organization in your area can have the same website as you. Usually this is the physical address where your church meets or where your organization is located.
 
What is the primary domain name (URL)?

If you don't have one registered yet, please skip this question.
 
Who will be the primary contact?

 
First Name? *

 
Last Name? *

 
Your role? *

Pastor, Administrator, Owner, Elder, etc.
 
Your mobile phone number?

 
Which Design would you like to use? *


 
Would you like us to include any of these add ons? *


 
Will the Billing Contact be the same as the Primary Contact? *

The Billing Contact is the person who will receive the initial invoice as well as monthly invoices.
     
 
Billing Contact's Information:

 
First & Last Name? *

 
If you've discussed any discounts or coupons with our sales team, please note them here:

 
If you have any questions before submitting this form, please feel free to give our Sales Team a call at 1-800-409-6631 x1!

Thank you! You will receive an email shortly describing the next steps of the process. We look forward to partnering with you!
Visit our website!