Affiliate Application

Yes! I'm interested in becoming a Reliance Ministry Affiliate Center.

There's no obligation for those interested in applying, but it is the first step in learning more about how partnering with Reliance Ministries could help your center grow!

First Name

Last Name

Organization Name

Phone

Do you currently run or work at a pregnancy center or maternity home?

What is your current role at the center, maternity home, or with a pro-life ministry? Please tell us about your organization and your role.

Please share your center's website(s) and contact information.

What are your view on life issues? What does it mean to be pro-love? What does it mean to be pro-abundant life?

How did you hear about us?

Thank you for your interest in learning more about becoming an affiliate. We will be in touch shortly!

Transforming Communities With Hope