We would love to hear from you! Please fill out this form and we will get in touch with you shortly. Step 1 of 6 16% Name* First Last Address* Street Address Address Line 2 City Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Americas Armed Forces Europe Armed Forces Pacific State Zip Code Email* Website* Pastoral Title:* Have you planted a church before? If so, how many?* Please share your church's story.* Are you willing to receive further training from our cooperating churches within REBUILD?* Yes No If you are a planting church, what kind of training are you providing for your prospective planters?* Please describe the training you require for your prospective church planters. Seminary* Yes No Internship(s)* Yes No Other:* Please describe why you want to plant a church.* Please describe what you consider to be the central components of your church (i.e., structures, ministries, etc.).* Is your church plant new or existing:* First Choice Second Choice Third Choice City, State/Metro Area:* How did you choose your location?* Who is your existing support team (financial and spiritual)? Supporting/Partner Churches:* Core Team:* State Agencies:* Individuals:* Businesses:* How long have you been in this metro area?* If this is a new plant, what is your desired launch date?* If this is a new plant, what is your desired launch date?* Have you read, and do you affirm, our statements of faith?* No, I have not read them. Yes, I have read them and affirm them. Please list at least 3 personal references we can contact, if needed. 1 Name Relationship Contact Number Email Address 2 Name Relationship Contact Number Email Address 3 Name Relationship Contact Number Email Address 4 Name Relationship Contact Number Email Address