Request for placement on the National Project List must
be approved by the UMVIM Jurisdictional Coordinator in which the project resides. That person will then send the form to the Volunteers in Mission Office of the North Central Jurisdiction of The United Methodist Church (UMVIM, NCJ) for listing.  		For UMVIM, NCJ office use only:

Project Number ________

Date Entered ___________

UMVIM, NCJ
928 4th Street, Office #2
Brookings, SD 57006
Tel 605/692-3390; Fax 692-3391
E-mail: umvim-ncj@brookings.net

U.S. Project Profile
Location __________________________________ Date of information  ______ / ______ / ______
Street address ______________________________ Gen Adv. Spec # (if any)  ____________________
City/State/Zip ______________________________ Conf Adv. Spec # (if any) ____________________
Phone (         ) _________________     Fax (         ) __________________     E-mail ________________________
 
Primary Contact Person _________________________ Backup Contact Person ______________________
Office Phone  (         ) ____________________________ Office Phone  (         ) _________________________
Home Phone  (         ) ____________________________ Home Phone  (         ) _________________________
E-mail  _______________________________________ E-mail  __________________________________

Number of Teams Needed  ____________ Project will be ready to receive volunteers as of _____ / _____ / _____
Number of People Per Team ___________  Dates to be avoided _____ / _____ / _____  -  _____ / _____ / _____
Remaining Project Cost _______________ Amount requested from local sources $__________________
Amount requested from UMVIM $______________________
Project Description (Briefly describe the project to interest and inform prospective volunteers.)

 
 

 
 


 
Other Opportunities (Briefly describe any additional opportunities available for mission in addition to the project itself. If necessary, attach additional information to this form.)
_____________________________________   _______________________
           Jurisdictional UMVIM Coordinator                           Date

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