Chamber of Care Connection Form
Whether you are seeking care, exploring a pathway, or interested in serving or partnering, we'd love to hear from you. Share a little about what brings you here so we can explore the right next step together.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
How would you prefer we contact you?
*
Email
Phone
Text
City & State
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How would you like to connect with the Chamber of Care?
*
Receive care or prayer
Explore a program or community
Serve with ERMI
Become a care partner
I'm not sure where to start
Which pathways interest you? Select all that apply:
*
Ministers of Freedom (Identify barriers and connect with care and practical resources for your next steps.)
Reformers Arise! (Gather, study, pray, and prepare with believers who see a need for repair and rebuilding.)
FORMED. (Explore what you're sensing though prophetic discernment and vision strategy.)
Transition + Formation - Favored Together (Prepare for what's next through workforce, leadership, and personal development.)
Help Make Care Accessible (Share your time, expertise, or resources through serving or partnership.)
I'm not sure. Help me find the right pathway
Which areas would you like support in?
*
Physical health
Emotional health
Finances
Time
Geography
Not sure
Other
What gifts, experience, services, or resources would you like to share?
Briefly share what brings you here, the support you're seeking, or how you'd like to contribute.
*
How did you hear about ERMI?
*
Referral
Event
Social Media
Other
May we contact you about this request?
*
Yes, ERMI may contact me using the information provided.
No
Privacy & Confidentiality
Your responses are kept confidential and used internally to prepare for your Conversation and align appropriate guidance and support. They are not shared publicly or externally.
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