DCMIAN Individual or Intercessory Partner

Please completely fill out this application.

Name (First, Middle, Surname)

Street Address

City , State , Zip , Country

Phone Number

Fax

Cell Phone

Date of Birth

Sex

Race

Marital Status If "Other"

Spouse's Name Date of Birth

Do you have Children?

Children names and ages:

How did you hear about Destiny Churches & Ministries International Network?

Why do you want to be affiliated with DCMIAN

Please give a brief description and history of you and your family

How do you see yourself involved in advancing the Kingdom of God?

Have you been actively engaged in regular public ministry?

What church are you currently actively involved?
Include name of organization, address, phone, website, person in charge (if other than yourself).

Briefly state how DCMIAN can help you walk fully in your destiny?

Briefly describe your vision and destiny that God has called you to. What results have you seen pertaining to your destiny?

Please give references of two persons who are in ministry (one must be from other than the ministry listed above) who have known you for at least six months:

1. Please provide: Name Position Phone number Email Address

2. Please provide: Name Position Phone number Email Address

Submitting this application indicates that you agree with our purpose and faith statements. Destiny Churches & Ministries International expects you to do your best to be an ACTIVE, SUPPORTING member of the network.

Applicant’s Signature Date:
(This constitutes an electronic signature)

Comments:

To submit please enter the characters you see in the image on the right into this space:
note: all letters are lower case.

Please email a recent photo and any other necessary attachments to apply@dcmian.com.