Disciple-Making Intensive Application

1
Are you trying to apply for LiNC?

This application is exclusively for those participating in the Disciple-Making Intensive only. If you'd like to apply for our 4-week LiNC project, please click here. Otherwise, click Next.
2
Name
First Name
Last Name
3
What is the name of your sending church?
Atlanta House Church Network
Awaken Church (Jacksonville, FL)
Blacksburg Ablaze Church (Blacksburg, VA)
Clemson Community Church
Cypress Fellowships (Orlando, FL)
Evergreen Community Church (Manassas, VA)
Freedom Bible Church (Enterprise, AL)
Gator Christian Life (Gainesville, FL)
Grace Community Church (Raleigh, NC)
Impact Christian Life (Norfolk, VA)
La Roca/The Rock (Atlanta, GA)
Niner Christian Life (Charlotte, NC)
Oak Ridge Community Church (Maryland)
Seminole Christian Life (Tallahassee, FL)
The Journey Church (Palm Coast, FL)
The Rock Miami
Other
4
Date of Birth
Date
Year
Month
Day
5
Gender
Male
Female
6
Phone Number
Area Code
Phone Number
7
Are you able to receive text messages at the phone number you provided?
YESNO
8
Email
example@example.com
Email Verified
The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification
••••
Didn't receive verification code? or
Receiving the email may take a few minutes, thank you for your patience!
9
Current Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
10
If room is available, would you like to stay with someone from Niner Christian Life while you are attending the Disciple Making Intensive?
YESNO
11
If you answered YES to the previous question about housing, please tell us the number of people needing accommodation.
12
Do you, or does anyone in your family, have special dietary needs? Please tell us about those needs here.
13
Name
First Name
Last Name
14
Relationship to you
15
Phone Number
Area Code
Phone Number
16
Email
example@example.com
17
Additional contacts or commentsPlease keep any comments posted here to the subject of emergency contacts. You will have an opportunity at the end of the application to leave any general comments you would like us to consider.
Huge
Large
Normal
Small
Ok
Ok
18
Thank you for applying to our 2024 Disciple-Making Intensive! We look forward to how God will use this time in your life and in the lives of others.

Our staff will send out important updates about our housing arrangments, schedule and other details as the time draws closer. In the meantime, if you have questions, please reach out to us at any time. We're excited to see you in May!

Hit "Submit" below, and you're all done! :)
Should be Empty: