Thank you for applying to become part of the CJA leadership team!
All fields are required. If you don't have an answer, please enter "None". And of course, be honest!

First Name

Last Name


How did you find out about CJA?


Where are you interested in creating a chapter or helping to lead a chapter?

What is the closest larger city near you?


Do you belong to any Jeep or off-road clubs? If so, which clubs?


Your Jeep: Year, Model & 2 or 4 Doors


What do you love about your Jeep or Jeepin?

Do you consder yourself a...

 Rock Crawler


 Mall Crawler

Daily Driver 

None of the above

On a scale from 0-10 (10 being a lot) how much expierence do you have with Facebook Groups?

Name of the church (& city) you worship at every Sunday.


Favorite Bible Verse

Is their a photo of your Jeep on your FB page? Yes No

Do you or have you posted Bible verses on your FB page? Yes No

Do you witness to your unchurched friends? Yes No

What is the Great Commission all about?  (No Googling)

Finish this verse " To the ends of the___________." (No Googling)


Ministry Experience and/or Ministry Training

Evangelism Experience and/or Evangelism Training


What's something you would like to share about your family, ministry or Jeep?


Your Email

Phone Number

  Is this your cell phone?   Yes


Address Line #2







Why do you want to create a CJA Chapter?

When you submit this from you will see "Thank You". If you don't see "Thank you", scroll up and provide the missing information.   Please allow us 1-2 weeks to review your application. If we think you are a good fit, we will contact you to schedule a phone interview. Thank you!