Name * First Name Last Name Email Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### How many children do you have? * What is your marital status? * What is your employment status? * What is your Facebook and Instagram Handles? * Select a Program(s) you would like to join * IMT- Individual Ministry Training Church Ministry Training Branding Church Startup logistics (KMM) Kingdom Model Mentorship KMM Business Mentorship What experience do you have in Ministry? * What experience do you have in the marketplace? * Why do you want to be apart of Leadership Re-Up? * What value do you bring to Leadership Re-Up? * What are your expectations in joining Leadership Re-up? * Will you be applying for a scholarship? * Yes No Thank you!