Volunteer Grant Application

Diocese of Davenport Volunteer Program _Online Application
Application for Short-term Mission Trip

Please mark one Team Individual

Designated for parishes in the Diocese of Davenport

First Name REQUIRED Please fill out this field. Please enter valid data.

Middle Name Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Parish/School REQUIRED Please fill out this field. Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Day Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Cell Phone Number Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Country/State to Visit REQUIRED Please fill out this field. Please enter valid data.

Date Beginning REQUIRED Please fill out this field. Please enter a date.

Date Returning REQUIRED Please fill out this field. Please enter a date.

What organization is sponsoring this trip? REQUIRED Please fill out this field. Please enter valid data.

Will you have short-term mission training prior to mission experience? REQUIRED Yes No Please fill out this field.

Who or What organization will be responsible for the training? REQUIRED Please fill out this field. Please enter valid data.

Please describe your group's relationship to the sponsoring organizatio as appropriate REQUIRED Please fill out this field. Please enter valid data.

Will you have a debriefing after your mission experience? Yes No

Will your parish assist in funding? REQUIRED Yes No Please fill out this field.

If yes, how much? Please enter valid data.

Cost of the trip $ REQUIRED Please fill out this field. Please enter an integer (number).

Amount requested from committee $ REQUIRED Please fill out this field. Please enter an integer (number).

Are you a parish member? REQUIRED Yes No Please fill out this field.

How long? Please enter valid data.

Describe the mission opportunity to which God has called you REQUIRED Please fill out this field. Please enter valid data.

Will this mission trip be a joint effort with another parish? Would you be willing to include members of other churches on this mission trip? REQUIRED Please fill out this field. Please enter valid data.

How do you expect to finance your expenses? (Travel, Room and Board, etc.) REQUIRED Please fill out this field. Please enter valid data.

What ministry experience have you had in your local parish, community and abroad? REQUIRED Please fill out this field. Please enter valid data.

What are the goals and objectives of the mission? How will you share the experiences with your parish? and with the diocese? REQUIRED Please fill out this field. Please enter valid data.

Two References (Individual Grants)

First Reference First Name REQUIRED Please fill out this field. Please enter valid data.

First Reference Last Name REQUIRED Please fill out this field. Please enter valid data.

First Reference Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Second Reference First Name REQUIRED Please fill out this field. Please enter valid data.

Second Reference Last Name REQUIRED Please fill out this field. Please enter valid data.

Second Reference Phone Number REQUIRED Please fill out this field. Please enter a phone number.

We prefer that you complete the online application form down below. If you must use hard copy or complete in word please click link Grant Application

Please return the completed application to:

Diocese of Davenport
Attn: Kent Ferris
780 West Central Park Ave
Davenport, IA 52804-1901

OR e-mail it to Esmeralda Guerrero, [email protected]