Men's Support Intake Form - Apostolic Moral Purity

Men’s support Intake form

Please complete this information form completely. We will contact you soon.

Your Information

Name(Required)

First Last

Age(Required)

Marital Status(Required)

Email(Required)

Phone(Required)

Time Zone(Required)

Best Time to Call(Required)

How old were you when you first saw pornography?(Required)

Additional Comments

Group Guidelines Consent

Your Consent(Required)

I agree to the Support Group Guidelines.

It is essential to understand that you are not alone. We are a group of Apostolic men who struggle with various forms of sexual brokenness and are here not only to address the behavior but, more importantly, to identify the underlying causes and find healing. No matter what brought you here or how difficult your situation is, you are welcome. This is a safe space. To maintain this safety, please follow the guidelines below.

1. Confidentiality is, first and foremost, the foundation of the AMP culture and is required for acceptance into the group. No group member is to repeat any information shared by group members outside the group. In addition, to protect the culture of safety and confidentiality that comes with joining a recovery group, no group member is to approach or show familiarity with other members of the group in church settings, district meetings, national conventions, or other public venues unless both parties have previously agreed to this being acceptable and are comfortable with being seen together.

2. No “fixing” during group discussions; only offer encouragement and understanding. We are not here to tell each other how to fix things but to “consider one another to provoke unto love and to good works” (Hebrews 10:24). Any feedback between participants, with permission from the person you’re giving it to, should provide encouragement or gently point out blind spots with love and allow for self-discovery in the primary sharer, prompting them to work through the process of personal growth and healing childhood wounds. Please refrain from interrupting, preaching, giving unsolicited advice, or judging others in the group.

3. All participants are expected to attend and keep their cameras on during group meetings, unless they are working. Newcomers are allowed a two-week period to “warm up to the group.” After this, they should participate in discussions and interact with others. Sharing during discussions helps the sharer and often benefits others facing similar issues who need someone to relate to. Refusing to participate deprives the group of insights from your life experiences and weakens the group’s safety culture. Healing only comes through connection, which cannot happen with a blank screen and a muted microphone.

4. While sharing, please generalize as much as possible to avoid triggering other people’s thoughts. Avoid using name-brand items that promote addictions. Refrain from sharing specific details in a group setting, especially when they involve others. Sometimes, you need to address specifics in detail, but that should be done with a counselor or someone qualified to guide you.

5. We ask that you refrain from driving while attending and stay attentive to get the most benefit. It is a good practice to have a notepad available during the group meeting. If you can’t focus during the meeting, please turn off your video and mute yourself. Please notify us in the chat if you are driving or can’t pay attention, so we are aware. Ensure your Wi-Fi connection is strong.

6. The group is an excellent place to build your accountability team. Connecting with 5-7 men, with at least one phone call each day, is recommended.

7. This is a group of Apostolic men. Please be mindful of your clothing choices. We are casual, but not excessively so. Please wear shirts with sleeves and pants with legs.

8. While Apostolic Moral Purity is developing closed groups that may have a cost, this support group will always be free. That does not mean there are no costs involved in providing the free services. You are encouraged to make offerings to AMP periodically, which can be done on the website.

9. We aim for this group to be enjoyable. However, remember the primary purpose: we are here to find healing. We are also here to support other men’s journeys toward healing. Keeping this in mind will help you speak and present yourself appropriately. It’s a good idea to communicate with God before going online.

10. Once you’ve been participating for a while, you may be asked to assist with the meeting. Please be willing to do so. Some of you will be asked to facilitate a meeting when you’re ready. It is essential to recognize that while this is about you, it is also about preparing yourself to assist others.

11. GroupMe is a messaging app used by AMP groups to communicate and check in with each other. Please be respectful of what you communicate. Please do not post anything that does not apply directly to this journey. You may post prayer requests. After 60 days, inactive members may be moved to the inactive support GroupMe room. You can reach out when you are ready to re-engage. Communication and connection are vital for the entire group.

Download Group Guidelines

Confidentiality Statement

At Apostolic Moral Purity, we are committed to maintaining the highest level of confidentiality and privacy for all members. Any personal information, stories, or details shared—whether in written form, verbally, or through any submissions—will be treated with the utmost respect and discretion. We affirm the following:

All information shared within the group or submitted to group leaders will remain confidential and will not be disclosed outside the group without explicit written consent from the individual.
Group facilitators and volunteers are bound by this confidentiality agreement and are trained to handle all shared information with care and professionalism.
Exceptions to confidentiality will only occur if there is a legal obligation to report imminent harm to oneself or others, suspected abuse, or as otherwise required by law.

By participating in this support group, you agree to uphold this standard of confidentiality for yourself and fellow members. Trust and safety are foundational to our community, and we thank you for honoring this commitment.