Your Name (required)

Address (required)

City (required)

ZIP (required)

Phone (required)

Your Email (required)

What faith community are you a part of? (required)

Are you in good standing with your faith community? (required)
YesNo. (please explain below)

Explanation

Please state your motivation for participating in the Emerging Church Leadership Institute (ECLI). (required)

How will the ministry you lead benefit from you participating in ECLI? (required)

Reference: Please provide the name and contact info of a ministry leader who knows you personally. (required)