Organization Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

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Address where VMMers will be parked

***IF YOU USE A COMMERCIAL RV PARK, IT MUST BE AT YOUR EXPENSE***

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Main Contact Person For VMM Crew Leader *

This will be the main contact point for VMMers

First Name

Last Name

Main Contact Phone # *

(###)

###

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HOLD HARMLESS CLAUSE: We have read all of this Application for Assistance and understand it. We, to the best of our knowledge, answered all questions honestly and correctly. We agree to reimburse any Volunteer Mobile Missionaries member for materials purchased with authorization from us. We agree to HOLD HARMLESS THE Volunteer Mobile Missionaries (VMM) and its members from any and all responsibilities and/or liabilities connected with any work project we are involved with. *

By checking this box and typing your name below, you agree to these terms.

*

First Name

Last Name