Recovery Alive Interest Contact Form

Are you interested in opening a Recovery Alive Ministry at your church or in your community? Maybe you would like to bring Recovery Alive to a prison or jail near you?

Fill out this form and a National Coach will get in touch with you soon! We look forward to partnering with you!

First name

Last name

Phone Number

Please provide your mailing address to receive an information packet:

Multi-line address

Country/Region

Address

City

Zip / Postal code

Have you spoken to a Recovery Alive National Coach?

Yes

Name of Church or Organization you are a member of:

What type of Recovery Alive Ministry are you wanting to launch?

Where will your Recovery Alive Ministry be located? Please provide the city and state so we pair you with the National Coach nearest to you!

How did you hear about Recovery Alive?

Why do you want to start a Recovery Alive Ministry?