Membership Application

Today's Date*
Birth Date month/date/year*
Name*
Address*
City/State/Zip Code*
Phone Number*
E-mail Address*
What is your marital status?
 Divorced
 Divorced with children under 18
 Married
 Married with children under 18
 Separated
 Separated with children under 18
 Single
 Single with children under 18
Church Name , Address, and Phone Number*
Do you serve in ministry full-time, part-time or as a volunteer?*
What is your denominational affiliation?*
List your area(s) of responsibilities in ministry.*
What are your current self-care interests and/or needs?*
What are your self-care practices?*
What woman in the Bible do you relate to the most and why?*
Which areas are you interested in participating?
Bathesheba's Blogs
Esther's S.P.A. Retreat
Eve's Events Planning Ministry
Hagar's Self-Care Workshops
Hannah's Prayer Ministry
Lydia's Leadership Institute
Martha's Cafe' Chats
Mary's Bible Studies
Miriam's Membership Ministry
Naomi's Mentorship Ministry
Phoebe's Praise & Worship Ministry
Rhoda's E-Newsletter
Ruth's Book Club
Women at the Well Renewal Workshops
Other interests: (please specify)
Are you applying for General or Premier Membership (General $15 or Premier $60/yr.)*
How did you heard about DIVAS for Christ:*
Does your computer have webcam capability?*
 Yes
 No
Premier members have full website access and receive discounts to special events. Make sure you have applied for a user login and password. Have you?*
By submitting this application, you agree to abide by the terms of use. Have you read and do you understand the guidelines? Please indicate with Yes or No in the box below. *


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