Ministry Application≈

Name:______________________________________________________________

Address: ____________________________________________________________

Ministry Name: _______________________________________________________

Ministry Address:______________________________________________________

Office / Ministry Phone number:_________________ Alternate Number:_____________

Email address:_____________________________

Website: __________________________________

Can we contact you via facebook? _______________ If yes, please explain how: __________________________________

1.  Please describe the ministry you are involved in: _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

2. Are you affiliated with a Denomination? __________________If yes, which one?_______________________________________

3. What is your monthly Budget? _________________

4. Are you at budget? _____________________ Please explain: ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

5. How are you currently being supported?________________________________________________________________________________________________________________________________________________________________________________________________________________________________

6. What accountability do you have in place? ______________________________________________________________________________________________________________________________________

7.Do you have a sending organization? _____________ Please Expound: _______________________________________________________________________________________________________________________________________________________________________________________

8. Are there any special projects you are raising funds for? __________  If yes, please explain: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

9. Are you or a family member currently supplementing your income with a secular job? _______ If yes, please explain: _______________________________________________________________________________________________________________________________

10. How would you like HPGF to assist you in ministry? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

11. Do you have any professional / sending church / or personal references that we could contact to speak with regarding the ministry you are involved in? ____________ If yes, please list name and contact information below:

12.  References name:                                                  Contact Information: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________

13. Please list any community service you participated in and explain in details what your role was. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________

14. Were you in any leadership roles in the last 4 years? _____ Please explain: __________________________________________________________________________________________________________________________________________________________________________________________________________________________

15. Is there anything you would like to add? _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

16. If you are a recipient, do we have authorization to publish this on social media and our website? ___________________________________________________

I certify the information provided is complete and accurate to the best of my knowledge and understand that falsification of information may result in award termination.

Signature: __________________________________________________________________________

Full Name (Please Print) ___________________________________________ Date: __________

Please attach any pictures, correspondence, ministry information and /or references you would like us to review.

Please scan this application with attachments and email it to: HealthProfessionalGF@gmail.com.