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Insurgence Experience Mastermind Application

Make sure you type your email address in correctly or else we won't be able to send you the registration page when registration opens.

First Name:

Last Name:

Email (type correctly):

Your Age:

Are You Male or Female:

Where do you live? (list state - country if outside USA):

What is your ministry? (lead pastor, assistant pastor, missionary, professor, teacher, etc.)

How many adults do you preach/teach to every week? (in-person, not virtually)

Church or Ministry Website Where You Preach or Teach:

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