Please enable JavaScript in your browser to complete this form.Personal InformationName *FirstLastAddress *Address Line 1Address Line 2CityState / Province / RegionPostal CodeEmail *Phone *Faith-Based InformationDenomination *Pastor's Name *FirstLastPastor's Contact Phone *Pastor's Email *Church Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeChurch Phone *Church EmailIdentification PictureUpdate photo on file?File Upload Click or drag a file to this area to upload. By checking this box, I certify that the UPCI Pastor above has approved and will endorse me for the Life In Focus Education certification. *By checking this box, I certify that all information submitted with this renewal is accurate and complete. I understand that providing false information may result in revocation of my certification and the imposition of administrative penalties.Once you have hit the submit button, you will need to add the renewal to your cart and complete the transaction. This renews all certifications on file. Submit Renewal Certification $50.00 – $65.00 Select options
Renewal Certification$50.00 – $65.00