JD Network Application

JESUS DISCIPLE NETWORK APPLICATION
Network Leader Information

help us get to know you
Your Name*

Leader First NameLeader Last Name
Spouse Name (if applicable)
Your Spouse's Name
Co-Leader Name (if applicable)

Co-Leader First NameCo-Leader Last Name
Email Address*

Confirmation EmailConfirm email address
Primary Contact Number*
Your Primary Contact Number is:

Mobile PhoneWhatsAppOther (please explain)
Your Network

a few details about your network
What is your proposed network name?*
Public name of your network (example: City Church Ministry). Recommend 20 characters or less including spaces (limit 30).
What language will your Jesus Disciple network be in?
What City and State/Province will your network be in? *
City and State / Province
What Country will your network be in? *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Network Directory

help other people find your network
How might people know or recognize your ministry?*
List the primary 1-3 ministry names that people might use to search for your network (e.g. church programs, ministry DBA, partner ministries, people).
Network Description (1–2 Sentences)*
One to two sentences that describe your network, perhaps names of leaders, teachers, locations, programs, etc. You're answering this question: "What words or phrases might someone type when searching for my network?"
About Your Ministry

help our team get to know your ministry
What is the name of your organization or ministry?*
How many total years has this ministry been active? *
How many years have YOU been the leader of this ministry? *
How many people does your ministry currently serve?*
What people group does your ministry primarily serve?*
Examples: young families, college students, local community members, refugees.
What organization or denomination does your ministry associate with (if any)?*
Please provide us with your ministry's primary website URL:
We'd love to know...
How did you hear about Jesus Disciple? *
How do you believe Jesus Disciple can help your ministry? *
What's next?

Once you SUBMIT your application our team will contact you at the email address you provided to schedule a brief video call. Be watching for an email from our team, and then reply so that we can help you get started. We really look forward to serving you! – The Jesus Disciple Networks Team
Leader First Name*
Leader Last Name*
Spouse Name

First NameLast Name
Spouse or Co-Leader Name (if applicable)

Spouse or Co-Leader First NameSpouse or Co-Leader Last Name
Co-Leader First Name (if applicable)
Co-Leader Last Name (if applicable)
Where do you live? (network leader)*
City, State, Postal Code, Country
Leader Phone Number
Please enter a valid phone number.
Should be Empty:

JESUS DISCIPLE NETWORK APPLICATION

Network Leader Information

Your Network

Network Directory

About Your Ministry

We'd love to know...

What's next?