| Request for placement on the Project List must be approved and signed by the Judicatory Head of the church. A cover letter with that approval may accompany multiple Project Profiles. |
|
Return
to: UMVIM, SEJ 315 West Ponce de Leon Ave. Suite 750 Decatur, GA 30030 USA Fax: 404-377-8182 |
| Signature (Head of Church) / Date ________________________________________ |
|
INTERNATIONAL PROJECT PROFILE |
|
| Country _____________________________ | Date information taken ____ / ____ / ____ |
| Location _____________________________ | Gen Adv. Spec # (if any) __________________ |
| Project Name _________________________ | Conf Adv. Spec # (if any) __________________ |
| Nearest Airport _______________________ | |
| Description of Project: | |
| Contact Person in Receiving Country | in Sending Country |
| Name __________________________________ | Name __________________________________ |
| Address ________________________________ | Address ________________________________ |
| ________________________________ | ________________________________ |
| ________________________________ | ________________________________ |
| Work Phone _____________________________ | Work Phone _____________________________ |
| Home Phone _____________________________ | Home Phone _____________________________ |
| Fax ____________________________________ | Fax ____________________________________ |
| Email __________________________________ | Email __________________________________ |
| Best time / day to call ______________________ | Best time / day to call ______________________ |
| Number of Teams Needed ______ | Project will be ready to receive volunteers as of ___/___/___ |
| Number of People Per Team _____ | Dates to be avoided ____/____/____ |
| Youth Accepted ___Yes ___No | If Yes, minimum age ________________ |
| Remaining Project Cost _________ | Amount to be raised locally _________________ |
| Amount requested from each UMVIM team ____________ |
|
Building
information |
|
| Length _______________ |
Makeup of Foundation _______________________________________ |
| Width ________________ | Makeup of Walls ___________________________________________ |
| Height _______________ | Makeup of Wiring __________________________________________ |
| Makeup of Roof ___________________________________________ | |
| Makeup of Plumbing ________________________________________ | |
| Electricity available on site? ____ Yes ____ No ____ 110 ____ 220 | |
| Can materials arrive on-site before teams arrive? __________ | |
| Specific Skills Needed ________________________________________________________________ | |
| Specific Tools Needed ________________________________________________________________ | |
| General Building Information: |
|
|
Medical information |
| Is there a clear need for medical services? |
| Is there a base medical structure that exists presently? |
| What is the attitude of the local
medical community toward medical volunteers? |
| List any medical personnel needed: |
| Describe working conditions: |
| Describe procedure for government
clearance: |
| General Medical Information: |
| Other
opportunities for volunteers (such as Bible School for children, youth, or
adults)
Please complete all items where possible. If necessary, attach additional information to this form.
|
|
Host information |
|
| Type of host orientation ______________________________________________________________ | |
| Type of housing for team _____________________________________________________________ | |
| Distance from housing to project site ____________________________________________________ | |
| Total cost of in-country transportation ___________________________________________________ | |
| How will local personnel (volunteers) be used? ____________________________________________ | |
| ________________________________________________________________________________ | |
| Will a translator be provided? __________________ | Is there a local supervisor on-site? _________ |
| Will meals be provided for the team? _____________ | Will cooking facilities be available? _________ |
| Cost per person per day for room and meals _______ | Amount of coordination fee for team? _______ |
|
Cultural
information - Please complete the following items
if possible. Feel free to attach |
| How is the local church involved in the area? |
| What is the attitude of the government toward volunteers? |
| Area recreational opportunities for teams: |
| List any guidelines regarding dress, offensive habits, etc., that team members should know before arriving. |
* * *