Chapter President Membership Form

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Please fill out ONLY if you pursue opening a Destiny Arising Chapter in your area

Email *

www.destinyarising.net

Disclosure: By submitting this questionnaire you acknowledge that this does not constitute an automatic approval to form a chapter. After reviewing these questions if you get selected to move forward you will be invited to participate in a special meeting so we can get to know you a little bit better. We will make our final determination and notify you of our decision 30 days after our meeting. *

I have read, understood, and accept to participate in this process.

Required

Name *

DOB *

YYYY

Cell Phone Number: *

Postal Address: *

City *

State *

Zip Code *

Country *

Ministry/Church/Business Web page (if applicable):

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