UMVIM Individual Scholarship '10

[tomcamp]

2009 Individual Volunteer Scholarship Application

Applicant¡¦s Name ________________________________________________



Mail check payable to _________________________________________________________

And mail to __________________________________________________________________
Mailing address City State Zip


Church Affiliated with ___________________________ District ___________________


Placement Information

Project Name _______________________________ Departure Date ________________________

Location ___________________________________ Return Date ___________________________

Country _____________________________________________________________________________

Brief description of the work you will do__________ ____________________________________

______________________________________________________________________________

______________________________________________________________________________

_____________________________________________________________________________________


Yes, I attended Individual Volunteer training with ćUMVIM SEJ or ćGBGM .
ćNo, I have not attended training.
If you indicated yes, please provide the date you were trained. ___________________________



________________________________________________ ___________________
Individual Volunteer¡¦s Signature Date