MEMBERSHIP FORM Join us as we impact youth and transform the next generation of believers. Name * First Name Last Name Email * Phone (###) ### #### Date of Birth MM DD YYYY Address Address 1 Address 2 City State/Province Zip/Postal Code Country Preferred Contact Method Email Call Text Why are you interested in joining? Please share briefly why you want to become a member. What are you looking to gain from this membership? Community support, spiritual growth, networking, etc. Are you interested in any of the following? Please check all that apply. Volunteering Leadership Opportunities Group Activities & Events Online Community Engagement How did you hear about us? Friend & Family Website Social Media Event Emergency Contact Information Name, Phone, Relationship Additional Comments or Questions Feel free to share any other information or ask any questions. Thank you!