Please complete the form below to sign up:
Enter Client Code (if applicable):
*Organization Name:
*Street Address:
*City:
*State:
*Zip:
*Contact Name:
*Contact Email:
*Telephone:
Fax:
How long has the organization been established?
*Type of Organization:  (e.g. Church, School, Flower Shop)
*Purpose for Background Checks:
*Tax ID Number:
*Billing Contact:
*Billing Contact Email:
User Setup:
*Username: (6-25 Characters)
*Password: (Enter a password between 6 and 25 characters containing at least one uppercase character, one lowercase character, and one number or any of the following special characters (!,@,#,$,%,&,_,<,>)
Select if ordering credit history reports.

Further FCRA compliance documents are required, which will be forwarded to you upon sign up.
A physical inspection of your location is required by Federal Law. A one-time $75 fee will be charged to your credit card in order to provide credit reports.
Select your options below. For pricing, please refer to your partner pricing or services proposal.
 Current Customer  
Check here if you are currently a customer of Protect My Ministry. Please be advised that pricing for this program may differ slightly than your current pricing with Protect My Ministry.
 Discount Offer - 1  
Prepayment of $1,000. Basic for $9.95. Plus for $21.00 (+fees). Please use the credit card provided in my online signup.
 Discount offer - 2  
Prepayment of $2,000. Basic for $9.75. Plus for $19.50 (+fees). Please use the credit card provided in my online signup.
 Discount Offer - 3   
Prepayment of $3,000. Basic for $9.25. Plus for $18.50 (+fees). Please use the credit card provided in my online signup.
 Discount Offer - 4  
Prepayment of $4,000. Basic for $8.75. Plus for $17.50 (+fees). Please use the credit card provided in my online signup.
 Discount Offer - 5  
Prepayment of $5,000. Basic for $8.25. Plus for $16.50 (+fees). Please use the credit card provided in my online signup.
Click "Next" to enter Billing Information.