2023 CURE Clergy National Policy Summit Registration Application

Contact Details

Name

First Last

Email

Enter Email Confirm Email

Mobile Phone

Office Phone (if applicable)

Spouses Name (If he or she will be joining as well)

First Last

Address

Address Line 1 Address Line 2 City State / Province / Region ZIP / Postal Code Country

Questions for Submission

Dietary Restrictions?

Have you been to our Summit before? If yes, how many and when was your last Summit?

Are you a:

Pastor
Co-Pastor
Associate Pastor
Youth Pastor
Donor

Does your Church have a school?

Yes
No

Are you a subscriber to Black Community News?

Yes
No

Values and Worldview

Please rate each of these 10 topic from 1-5, where 1 is the least important and 5 is the most important, the urgency level of Americas most pressing issues:

Abortion

Economy

LGBTQ Agenda

Housing/Homelessness

Social Justice

Welfare Reform

Education Freedom

Social Security Reform

Reparations

Police Reform

Note: Spaces are limited. Sadly, we will not be able to accommodate all applications. Accepted applications will be confirmed by CURE's Clergy Center Director, Rev. Omarr C Peters, by late summer 2023.

I have read and understand these conditions