Grant Form | Trevor Roberts Memorial Mission Foundation

Personal Information

Name*

First Last

Date of birth*

MM

DD

YYYY

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Marital status*

Employer's name and address (if applicable)

Name and address of last school attended or currently attending

Year attending or attended

Church you are a member of and for how long*

Have you ever received a grant from us in the past*

Yes
No

How did you hear about us*

Mission Trip Information

Name of religious or mission organization trip is through*

Mission trip location*

Beginning date of trip*

MM

DD

YYYY

Ending date of trip*

MM

DD

YYYY

Describe purpose of mission trip*

Probable number of team members confirmed for trip*

Please enter a number greater than or equal to 1.

Cost of trip*

Please enter a number greater than or equal to 1.

Approx. other costs relating to trip*

Please enter a number greater than or equal to 0.

Have you sent any support letters*

Other methods of fundraising

Date funds are due*

MM

DD

YYYY

List any previous mission trips

Please write a brief essay explaining why you want to be a part of this trip, what your goals are while on this trip, and what you hope to gain from the experience. Pleas also include your reasons for requesting this grant.*

Please list any special circumstances relative to your proposed trip of which the board should be aware of.

You agree that all the information entered is correct to the best of your knowledge and that the Foundation has the right to decline any application. Upon your return, a written report regarding the trip must be submitted to the Foundation.*

Agree

Grant Request Form

Personal Information

Mission Trip Information