Preaching for Change Cohort Application

Preaching for Change Cohort Application

Part 1 - This form is to be filled out by one representative from the cohort.
I am filling out this application for:*

a Peer Cohorta Congregational Cohort

Application for Peer Cohort
Description of your Cohort*

Please give us a general description of your cohort. 0/250
How are the people in your cohort connected? How did it emerge?*
Point of Contact for the Cohort
Name #1*

First NameLast Name
Email #1*
example@example.com
Phone Number*
Please enter a valid phone number.
Additional Members of Cohort

Please list the other members of the cohort. Cohorts should consist of 5-8 members (total).
Name #2*

First NameLast Name
Email #2*
example@example.com
Name #3*

First NameLast Name
Email #3*
example@example.com
Name #4*

First NameLast Name
Email #4*
example@example.com
Name #5*

First NameLast Name
Email #5*
example@example.com
Name #6

First NameLast Name
Email #6
example@example.com
Name #7

First NameLast Name
Email #7
example@example.com
Name #8

First NameLast Name
Email #8
example@example.com

Application for Congregational Cohort
Description of your Cohort*

Please provide a general description of your cohort. 0/250
Congregation Information
Name of Congregation*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Denomination*
Point of Contact for the Cohort

This must be a member of the cohort, not an administrator.
Name - #1*

First NameLast Name
Email - #1*
example@example.com
Phone Number*
Please enter a valid phone number.
Additional Members of Cohort

Please list the other members of the cohort. Cohorts should consist of 5-8 members (total).
Name - #2*

First NameLast Name
Email - #2*
example@example.com
Name - #3*

First NameLast Name
Email - #3*
example@example.com
Name - #4*

First NameLast Name
Email - #4*
example@example.com
Name - #5*

First NameLast Name
Email - #5*
example@example.com
Name - #6

First NameLast Name
Email - #6
example@example.com
Name - #7

First NameLast Name
Email - #7
example@example.com
Name - #8

First NameLast Name
Email - #8
example@example.com
Congregational Support

Name and email information for your Congregational Representative (i.e Clerk of Session/President of Board) to confirm support. Note that an email will be sent to them upon submission of this application, and a response will be required for your application to be complete.
Name of Congregational Representative*
Email*
example@example.com

Application for Peer Cohort