Directory Update/Correction Form

Please fill out this form COMPLETELY to get your information added or corrected in the online directory. Please note: information will only changed on request. So please check your online listing before filling out this form and indicate "remove old info" or "keep old info" in fields where appropriate. This will allow us to keep the online directory up-to-date with members' most current information.

   
Full Name:                  Title:
     
Gender:    male     female                                    Ethnicity: 
     
School/Institution Name: 
     
School/Institution Street Address:
  City:    State/Province/Territory:
   Zip:   Country:  
 
Preferred Mailing Street Address:
  City:   State/Province/Territory:
   Zip:   Country:  
   
 Include Preferred Mailing Address in online listing: Yes     No  
   
Department:     
   
Rank (Assoc. Professor, Asst. Professor, etc.): 
   
Current Professional Status (teaching position, dept. chair, etc.) :
   
Email address:  
                               Email address required for proper processing of form
   
Office Phone:           Include in online listing: Yes     No
   
Fax Phone:         Include in online listing: Yes     No
   
Home Phone:        Include in online listing: Yes     No
   
Doctoral Degree Information  
  Theology/Related Field:  
  Received (Year):  
  Granting Institution:  
 

Dissertation Title:
  Dissertation Publication Date: 
  Publication Agency:
   
Major Field of Study: 
 
Areas of Specialization:
 
Three recent publications (title, publisher, publish date):
Start with most recently published item first and list in reverse chronological order
1.
   
2.
     
3.
     

        

Successful submission of your information will result
in the display of a confirming page.

 
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