Name* First Last PhoneEmail Are you a member of St. Andrew's Church Little Rock (SACLR)?* Yes No When did you become an SACLR member?When is your planned mission?*Please state the approximate month/year you plan to leave and the approximate month/year you plan to return.Where is your planned mission?*What training have you or will you be obtaining for this mission?*Who, if anyone, will be attending this mission with you, and what church(es) are they associated with?*What is the purpose of your mission?*Do you have a sending organization?* Yes No If yes, what is it?What and how much are your anticipated expenses?*Do you anticipate receiving funding form any other sources?* Yes No If yes, please state your other funding sources and the amounts for each, if available.Why are you wanting to do this mission?*What is your funding request (i.e. how much money are you seeking) form the Mary Frances King Short-Term Mission Fund?Why are you seeking this amount?*PhoneThis field is for validation purposes and should be left unchanged. Δ