Responding to spiritual and physical needs among the most vulnerable populations in East Africa
Breaking the cycle of poverty by providing clean drinking water, child sponsorship and community projects


Thank you for your interest in serving the Lord in Uganda or Rwanda. In order for us to get to know you better and to also make proper arrangements for you to have an exciting and fulfilling trip, please provide us with the information below as soon as possible. You can fax the information to: (916)941-8385. If you have any questions you can reach us by phone at: (916)941-8385

First name :  
Last name :  
Nationality :  
Date of Birth:
Is this your 1st foreign mission: trip?  Yes   No
Where would you like to serve?
Uganda Rwanda Both
Name of School/College/University:
(If applicable):
School/College/University address:
City / State / Zip code:
Home address:
City / State / Zip code:
Work phone:
Home phone:
Fax number:
Email address:
Marital status (Spouse's name):
When did you trust Jesus Christ as your Savior?
(Include approximate date and age) Write a brief
description of your experience:
Home church:
Home pastor:
Pastor's telephone:
Pastor's mailing Address:
Pastor's fax:
Pastor's email:
Desired ministry activities, in order of preference:
Are you willing to work with Christians from a wide
variety of other denominations?
 Yes   No
Why do you want to go to Uganda?
Mission Team
     Arrival in Uganda
Nakigo Water Well
Arrival in Uganda
Knitting Center