First Name *

First Name

Last Name

Phone *

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Please check a box to let us know which way you are participating: *

Individual participation. You will do all the reading on your own but will still be required to follow the reading schedule and participation in the private Facebook page with the rest of the team.

Small book club. If you have been personally invited by someone to participate in a small book club, please fill out the "book club" box below and let us know who your book club leader is. Be sure to include her last name and the city in which you will be meeting. Individual participation in private Facebook group is still required.

Leadership teams. If you belong to a leadership development team participating in our launch team, please fill out the "leadership team" box below and be sure to include the following: name and city of organization and your leader's name. Please know that individual participation in private Facebook group is still required.

Please check the boxes in agreement to the following: *

I understand that my participation in the launch team for the book, Peace in the Brokenness, is as a volunteer and no monetary compensation will be given.

I understand that this is a private launch team and prior to the release date of January 17, 2016, I will only share information or content of the book as directed by Gina Holm or the Peace in the Brokenness lead team members.

Because space is limited, I understand that my applying does not guarantee participation in the launch team. I will be notified of participation via email by October 31st.