Name of candidateName of church plant/ministryStart date of requestMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920End date of requestMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Name of requestorRequestors phoneRequestor email Total estimated cost for DATES REQUESTED for church plant / ministryAttach itemized budgetMax. file size: 50 MB.Funding breakdown for the church plant / ministryThe sum of items A-D must match the total estimated cost.A) Local church participation for dates requestedB) Associational participation for dates requestedC) Other funds for dates requestedD) Amount of grant for dates requested Record of sponsoring congregation’s mission support through the Cooperative Program (CP) over the past three years:201920202021Record of sponsoring congregation’s mission support through the State Mission Offering over the past three years201920202021 Δ