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* 1. Lead Pastor's Name

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* 2. Spouse/Co-Pastor's Name

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* 3. Church Name

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* 4. Church's Address

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* 5. Lead Pastor's Email

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* 6. Spouse/Co-Pastor's Email

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* 7. Lead Pastor's Cell Phone

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* 8. Spouse/Co-Pastor's Cell Phone

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* 9. Date You Planted the Church

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* 10. Current Average Attendance

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* 11. Please indicate if your church is affiliated with a denomination or network?

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* 12. Where does your church currently meet?

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* 13. Please share your and your spouse's bio

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* 14. Provide a summary of your church planting journey (include your church's vision, location in the city, demographic you are reaching, and any information that would be helpful for us to understand your ministry context and situation)

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* 15. What are your biggest leadership, church, or urban context challenges?

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* 16. What are the top four leadership topics you want to learn about?

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* 17. Are you and/or your spouse able to attend the 9 monthly 90-minute coaching Zoom calls (typically happen during a weekday).

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* 18. Are you AND your spouse able to attend the experience in Washington D.C. October 3-5, 2023?

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* 19. Are you able to pay the $395 Cohort Registration Fee and Flights for you and your spouse to Washington D.C. on October 3-5, 2023?

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* 20. Please upload a current photo of you and your spouse (one photo together)

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* 21. What questions do you have about the Urban Church Planters Cohort?

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* 22. I understand that if we are accepted to the Urban Church Planters Cohort, at least one of us will be expected to participate in the monthly coaching Zoom calls AND both of us will participate in Washington D.C. experience. We understand that our $395 registration fee will be due within 14 days of acceptance to the cohort. In addition, I understand I am responsible to purchase my and my spouse's flights to Washington D.C. for the event on October 3-5, 2023. If for any reason the cohort was cancelled, your registration fee will be fully refunded but your flights to Washington D.C. would be your responsibility. Please  indicate your agreement with your first and last name in the box below.

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