Print out the form, complete all sections, and e-mail  to:



City, State & Zip Code:

Name and Position:

Phone Number - Day:

Phone Number - Night:

E-mail address:


List three references, name, position and contact info:


    Are you prepared to document your efforts?

    How often will you need assistance?

    Please answer the following questions on a separate sheet of paper.
    Please type all answers.

    Tell us about your church?

    Tell us about this ministry/mission and its objective?

    Tell us about your experience?

    Explain who will receive these funds and how will they be used?

    How will this advance God's kingdom?

  • All applications must be accompanied by a copy of the IRS letter of determination for the organization. This is necessary to confirm the tax exempt status of the organization and that it is qualified to receive contributions.  No international applications will be accepted.