Date *
Personal Information
Name *
Date of Birth *
Date of Birth
Address *
Primary Phone *
Primary Phone
Secondary Phone
Secondary Phone
If applicable, is your spouse in agreement with your role in ministry and is he/she involved in HCI programs? If applicable, are your children involved? Please describe below.
Church/Ministry Information
What is the church or ministry you would like associated with your HCI membership?
What denomination is your church or ministry?
How long have you been involved with this church or ministry?
Church/Ministry Phone
Church/Ministry Phone
Church/Ministry Address
Church/Ministry Address
Interests and Experience
Ministry Interest
I am willing to serve HCI in the following ways (please select all that apply).
Experience Participating
Please check all of the following that you have attended as a participant.
Please list other experience you have as a participant, e.g. Thrive, Sozo, HeartSync, Christian Healing Ministry, Prayer at the Rail
Experience Facilitating
Please check all of the following that you have taught or facilitated (including as a co-teacher).
Please list other experience you have facilitating, e.g. Thrive, Sozo, HeartSync, Christian Healing Ministry, Prayer at the Rail
What books/videos have you read/watched, or conferences have you attended, related to healing and maturing?
More Background Information
Self-Care and Spiritual Support
We ask all leaders to have at least four intercessors. You will need to keep them informed usually through email. Do you have at least two intercessors who will be praying for you?
We ask that all leaders have a plan for what they will do if they are triggered and cannot resolve something on their own. What is your plan (e.g. receiving prayer from a friend or talking to my mentor/counselor)? One way to do this is to ask someone in your Leader Group to be a prayer partner with you.
Network Inforamtoin
Which monthly Leader Group are you willing and able to attend?
Groups meet once a month.
Have you read and do you agree with HCI's mission, vision, values and beliefs?
Mission, vision, values and beliefs can be found at:
We ask that our members support HCI financially (at any level). Are you able to make a financial gift?
We ask that you prayerfully consider how much God would have you give.
Network Application Checklist
Please check which of the following you have completed as of today.