CJA Affiliate Application

CJA Affiliate Application

What is the name of the Organization applying to the CJA Affiliate Program?*

Is the Organization located in the United States?*

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What Country is the Organization located?*

What is the address of the international Organization?*

Street Address*

City/Town*

State*

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Is the mailing address the same as the physical address?*

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Mailing Street*

Mailing City/Town*

Mailing State

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What is the Organization's telephone number?*

What is the Organization's website address?*

What type of Organization is applying?*

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Other Organization Type

How long has the Organization been in existence?*

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Is the Organization a tax-exempt, non-profit organization under section 501(c)(3) of the Internal Revenue Code?*

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What is the approximate membership of the Organization?*

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Does the Organization currently operate a K-12 school?*

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Which Affiliate Program(s) are of interest?*

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Briefly describe the Organization’s vision for offering or expanding K-12 education.*

Is the Organization able to host students at its facilities for in-person activities?*

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Name of person submitting this applicaiton*

Please provided the Title/Position with the Organization of the person submitting the application?*

Please provide the direct phone number of the person submitting the application.*

Please provide the best email address.*

Disclaimer Agreement*

I understand that by submitting this Affiliate Application on behalf of the named Organization, the Organization is requesting to be considered for Covenant Journey Academy’s Affiliate program and is consenting to be contacted by telephone, email, text, and/or other forms of communication.

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Please upload the Organizational Faith Statement*

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