International Director | Leader Profile Form

Thank you for being part of the Nehemiah Alliance event: Sundown September 10, 2026 – Sundown All Saint’s Sunday November 1,2026––a historic assignment. We truly could not do this without you. As we unite to Rebuild. Restore. Renew. our nation through 52 days of prayer, fasting, and repentance, your leadership is helping mobilize believers across America for such a time as this. We are honored to serve alongside you.

Nehemiah reminded the people, “The joy of the Lord is your strength” (Nehemiah 8:10). May the Lord strengthen your hands for the work, give you wisdom for every step, and use your faithful obedience to leave a lasting spiritual legacy for generations to come. We believe God will do immeasurably more than we could ask or imagine.

Please complete all required fields so our team can properly prepare, coordinate communications, and honor your participation. By signing up, you are invited to attend the grand finale event on the National Mall in DC on 10/31/26 Saturday, Reformation Day, but it is not required.

Full Name

Title/Role (e.g., Pastor, Director, Rep., Founder, etc.)

Phone Number

Organization/Ministry Name

Website (Write N/A if none)

Short Bio (please no more than 3 - 5 sentences)

Published Works (list any books you've authored or Broadcast & Media Platforms––television, podcast, radio, digital or streaming platforms you host, produce, or lead).

Social Media Handles (Write N/A if none available).

Lower Third Information

Please enter your name, title, and organization exactly as you would like them to appear on screen if your video is used in promotional or event materials.

Lower Third Name

Lower Third Title

Lower Third Organization

Are you willing to serve as a spokesperson for NA52 (news, TV, or radio)?

Yes No Maybe Other

If you selected “Other,” please explain:

Commitment Confirmation

I confirm my intent to attend in person or to participate in the Nehemiah Alliance event on October 31, 2026.

Yes No Other

If you selected “Other,” please explain:

Attendance

How do you plan on attending Nehemiah Alliance on Saturday, Reformation Day, 10/31/26?

In person at the National Mall I will be attending at a streaming location I'd be available to pray at event at the National Mall Other

If you selected “Other,” please explain:

VIP Seating on Reformation Day, October 31, 2026

Would you like VIP seating at our event taking place at the National Mall?

Yes No Maybe

Strategic Partnership Organization:

Please check the box below if you are interested in receiving additional information about being a "strategic partner organization."

Yes Other

If you selected “Other,” please explain:

Media, Name, Image & Likeness Authorization:

By submitting videos, photos, audio recordings, logos, or other media, I grant Nehemiah Alliance permission to use, reproduce, edit, publish, distribute, and display these materials, along with my name, image, voice, likeness, title, organization, and submitted content, for promotional, educational, broadcast, livestream, social media, website, and other ministry-related purposes without additional compensation. I affirm that I have the authority to grant these permissions.

I agree. Other

If you selected “Other,” please explain:

Photo/Media Release:

I consent to NA52 using my name, image, and bio for event promotion and media purposes.

YES, I give my consent. NO, I do not give my consent.

Media Uploads

Headshot Upload (high resolution, professional photo). Upload up to 5 supported files. Max 10MB per file
Acceptable formats: jpg, webp, png, avif, jpeg, heic, heif

Professional Headshot Upload