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

Fields marked with an ( * ) are required

PART 1 - PERSONAL INFORMATION

Choose Membership Level

Thank you for your interest in joining Christ Covenant Coalition! The following are the various levels of affiliation. Please select one of the following in addition to filling out the questionnaire that follows.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address

Mobile

(###)

###

####

Home

(###)

###

####

Date of Birth

MM

DD

YYYY

Age

Gender

Male

Female

What is your marital status

Single

Married

Divorce

Separated

Spouse's name

First Name

Last Name

CCC Member who Nominated You

First Name

Last Name

*Please correct errors before submitting this form.

PART 2 – MINISTRY/NETWORK INFORMATION

Name of your ministry/network/business

First Name

Last Name

Your Position

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Fax

(###)

###

####

Email

Website

http://

Where do you want your CCC communications sent to?

Personal

Ministry

Which information do you want to use for the membership directory?

Personal

Ministry

*Please correct errors before submitting this form.

PART 3 – EMERGING APOSTOLIC LEADERSHIP

1. Explain how you function as an Emerging Apostolic Leader:

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

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email

*Please correct errors before submitting this form.

NOTE: Membership in CCC 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.