TEXAS CHURCH SECURITY COALITIONMEMBERSHIP APPLICATION Church Name * Church Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Church Phone * (###) ### #### Church Email * Church Website * http:// Weekly Attendance * Church Contact Information * First Name Last Name Title * Email * Phone * (###) ### #### Safety/Security Team Contact Information * First Name Last Name Title * Email * Phone * (###) ### #### Church Member Annual Membership Fee List Please select based on weekly attendance Over 5,000 - $600 Annually 4,000 to 5,000 - $500 Annually 3,000 to 4,000 - $400 Annually 2,000 to 3,000 - $300 Annually 1,000 to 2,000 - $200 Annually 500 to 1,000 - $100 Annually 300 to 500 - $50 Annually 150 to 300 - $30 Annually Less than 100 - $25 Annually Leadership and Safety/Security Team Members First Name Last Name Email Phone (###) ### #### Safety/Security Team Member First Name Last Name Email Phone (###) ### #### Safety/Security Team Member First Name Last Name Email Phone (###) ### #### Safety/Security Team Member First Name Last Name Email Phone (###) ### #### Safety/Security Team Member First Name Last Name Email Phone (###) ### #### Safety/Security Team Member First Name Last Name Email Phone (###) ### #### Safety/Security Team Member First Name Last Name Email Phone (###) ### #### Safety/Security Team Member First Name Last Name Email Phone (###) ### #### Safety/Security Team Member First Name Last Name Email Phone (###) ### #### Safety/Security Team Member First Name Last Name Email Phone (###) ### #### Safety/Security Team Member First Name Last Name Email Phone (###) ### #### Safety/Security Team Member First Name Last Name Email Phone (###) ### #### Membership Affirmation and Terms This Church is a legitimate place of worship that supports the deeply held values of a benevolent God Yes No This Church supports the right of all people to be safe and secure worshipping, while present at churches, other faith based organizations, and schools, and at activities conducted by those organizations Yes No This Church supports the belief that worship services and other events should be allowed to proceed without interruption or disruption Yes No This Church supports the individual’s right to defend innocent parties, against unlawful force, and the individual right of law-abiding persons to bear arms, including on church property or at church activities Yes No This Church does not support violence against anyone (other than in defense of self or others) Yes No This Church agrees to support the values of the Texas Church Security Coalition, specifically including the belief that people of all religions should be kept safe while they worship Yes No Thank you!
