Leader Application

General Info
Name *
Phone *
Date of Birth *
Date of Birth
About Me
Have you ever been charged or convicted of a crime? *
Christianity, Church & Leadership
Are you a member of a church? *
Are you currently a part of an Embrace Bravery support group? *
My Future Group
If chosen to lead a support group, the following info is the information for my group.
Frequency of Meetings *
Time for Meeting *
Time for Meeting
Target Launch Date *
Target Launch Date
Type of Group *
Everything stated above in this form is true to the best of my knowledge. I understand that I am agreeing to become an Embrace Bravery leader and that by doing so I am agreeing to serve under the leadership and direction of the Embrace Bravery founder. I understand that signing this form means that I agree to become a leader with Embrace Bravery.