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     The Special Project Request form is an opportunity for you to bring awareness on a project in which you will need financial support. All information must be given in order for your project to be considered.

 

Name:		Date:
Address:
City, State, Zip & Country:
Email:
Fax:	Home Phone:     Office Phone:
Home Church:
Missions Organization:
Federal Tax or SS #:

Ministry Information:
     A. This information is required for your project to be considered. Please provide a brief descriptions and statistics about the different aspects of your ministry. Listed below are examples of what we are looking for.

1. How long has your ministry been established?

2. What type of outreaches do you have? How many a week? How many attend at each meeting?

3. Have you helped plant churches or orphanages? If so, how many and how many people have been reached through this ministry? How many attend the church(es)? How many children in the orphanages etc.? What do you provide for them (ex. meals, schooling, clothing etc.)?

4. Do you have outreaches? Example: Vacation Bible schools, Prison Ministry, After School Programs, if so how often and how many attend?

5. Do you have programs for children, adults within your church or to your community? If so, what kind and how often?

6. Do you have a training program for pastors? If so, how often do you meet, how many pastors are involved each month? How many have gone through your program? What do you provide to them (ex. housing, food, training materials etc.)?

7. Do you distribute ministry materials? If so, what kind of material (Bibles, tracts, etc.) have you distributed? To how many areas/ cities and how many people does it reach?

8. Do you teach trades? If so, what kind? How many people have been trained through your ministry? How many area/ cities are impacted?

Special Project Information:
Please provide a brief description of the project:

Location:

Approximate number of people that will be impacted:

Project Inception Date:
Projected Completion Date:

What phase of the project are you in now? :

Current project supporters (List references):

Name:
Phone:
Name:
Phone:

Estimated Project Cost:
Amount Raised or Pledged so far:
Deadline to Raise Funds:

If given funding I am willing to give Countryside Christian Center periodic reports as to project progress at least twice a year?
Yes     No

** Please note, upon submission of 2009 Special Project Request form, a "Thank You" pop up window will appear and once you click the OK button, you will return to this same page with the fields all empty. No need for concern as the form has been submitted successfully. Thanks! **