Hands On Mission Experience Form - Trinity Reformed Church

1. Name of Trinity Group (or requesting individual): *

2. Contact Person: *

3. Day Time Contact Number:

4. Evening Contact Number:

5. Contact's Email Address: *

6. Name of Sponsoring Organization:

7. Amount Requesting:

8. Date of the Mission Experience:

9. Date Money Needs to be Distributed:

10. If approved, who should the check be written to (Name & Address)?

11. How does this experience meet the mission and vision of Trinity Reformed Church?

12. What are the details of your experience (who, what, when, where, etc)?

13. How many people from Trinity Reformed Church will participate?

14. What do you hope to achieve spiritually, emotionally, etc. from your experience?

15. Total Endowment Request:

16. Do you need the entire asking to proceed with this Mission Experience?

17. Planned Mission Experience Financial Distribution - specific financial breakdown of your costs:

18. Additional Costs - what are they and how do you plan to meet these costs?