Primary Intake / Interest Form

the Private Members Association request

Welcome

By completing, you are expressing your interest in becoming acquainted with our Private Community. This is the first step toward receiving the Private Member Agreement and an invitation to our fellowship calls, newsletter, and community updates.

By sharing your private information you are affirming:

You wish to receive communication by email.
You agree this is an interest/application step and does not itself confer membership.

I affirm that I am a natural man or woman acting in my private capacity (not as an agent, officer, or representative of any public body).

Name

Email address

Location

Phone number

How did you hear about us?

I would like to receive private updates about calls, gatherings, and study groups.

What draws you to express interest at this time?

Consent & Intent

I request to receive the Private Member Agreement PMA (when available).

Newsletter & Updates - I would like to receive private updates, news, and resources by email.

Fellowship Calls - I would like to be invited to online fellowship gatherings. (attending 3+ calls is a requirement of joining as a member or shareholder)

Community Care Circle (Participant) - I would like to join as a participant and be included in invitations.

Community Care Circle (Lead / Facilitator) - I am interested in leading or co-facilitating a circle.

Other

Autograph

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