Membership Application

If you have decided that you would like to become a Member of CCC then please fill out the Application below. It will be processed immediately and you will be contacted by one of our Apostolic Council Members. Once you have been accepted as a Member you will then go online and set up your Monthly Dues payment at https://give.cornerstone.cc/christcovenantcoalition

FILL OUT APPLICATION BELOW OR DOWNLOAD & PRINT

Fields marked with an * are required - 

PART 1 - PERSONAL INFORMATION

Name *
Name
Address *
Address
Mobile *
Mobile
Home
Home
Date of Birth *
Date of Birth
Gender *
What is your marital status *
Spouse's name
Spouse's name
CCC Member who Nominated You
CCC Member who Nominated You

*Please correct errors before submitting this form.


PART 2 – MINISTRY/NETWORK INFORMATION

Name of your ministry/network/business *
Name of your ministry/network/business
Address
Address
Phone *
Phone
Fax
Fax
http://
Where do you want your CCC communications sent to? *
Which information do you want to use for the membership directory? *

*Please correct errors before submitting this form.


PART 3 – EMERGING APOSTOLIC LEADERSHIP

2. Provide the name of a person with knowledge of your ministry, to whom you are personally accountable: *
2. Provide the name of a person with knowledge of your ministry, to whom you are personally accountable:
Address *
Address
Phone *
Phone

*Please correct errors before submitting this form.


NOTE: Membership in US Coalition of Apostolic Leaders is restricted to individuals who have been recognized by a significant segment of the church, including peer-level apostolic leaders. It is intended to be seen as a professional society in which emerging apostolic leaders are able to relate to and connect with each other.