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

________________________________________
Title


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
Please complete all items where possible. If necessary, attach a description of the project to this form.

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
Please complete all items where possible. If necessary, attach additional information to this form.

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
Please complete all items where possible. If necessary, attach additional information to this form.

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
additional information as necessary.

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.

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