Elim Bible Institute - Student Ministry Host Request

Request a Student Ministries Team

*Organization Name:

*Address:

Address Continued:

*Pastor / Chaplain / Director:

*Office Phone:

Home Phone:

*E-mail:

Distance / Directions from Elim to your ministry

Miles one way:

Normal Travel time one way:

Directions from EBI to your ministry:

Maintaining clear lines of communication is essential. Please provide the name and phone number of the person who will be directly interacting with the Student Ministries Team and with the Ministry Department.

Contact Person

*Direct Contact Person / Title:

*Office Phone:

Home Phone:

*E-mail:

*Please describe your organization's focus and goals:

*Our goal is to effectively serve you and give our students solid practical ministry experience. What specific services could a Student Ministry Team provide for you?

Team specifics that best suit your needs:

Day of week:

Team Arrival Time:

Team Departure Time:

Team size needed:

Gender:

How many individuals are in the group or class which a Student Ministry Team would serve?

What is its age bracket?

Are there any restrictions or procedures that the team should know and observe?

Please state appropriate dress for team members:

Men:

Women:

Please Note: The required reimbursement for the cost of providing a team is based on $.35 per mile round trip. Please determine the round trip distance from Elim to your ministry: (miles). Please multiply that mileage by $.35: $ per team visit. (Example: 50 miles x $.35 = $17.50 per team visit).
Will your organization be able to cover these costs?
Your ministry will be reimbursing Elim Bible Institute on a
weekly monthly semester annual basis.
Please make all checks out to Elim Bible Institute with 'Student Ministry' in the memo line and mail to: EBI Ministry Dept., 7245 College St., Lima, New York 14485.

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