Project Application - Servant's Heart Ministry

Organization Name*

Organization Description

Type*

Organization Services*

Check all that apply

After School Programs
Church Services
Community Center
Community Development
Education
ESL Classes
Food Pantry
Funding/Investment
Government
Homeless Services
Immigration Assistance
Medical Care
Mentoring
Mission Trips
Sports
Youth Services

Organization Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Office Phone

Fax

Office Email

Website

Contact Information

1st Contact Name*

First Last

Title

In relation to the organization

Work Phone

Mobile Phone*

Email*

2nd Contact Name

First Last

Title

In relation to the organization

Work Phone

Mobile Phone

Email

Project Information

*Please note, Servant’s Heart Ministry does not have the funds to cover the materials or professional services needed to complete each project. Although we do our best to lower costs through donations and discounts provided by our business partners, we cannot guarantee we will have anything to offer.

How much funds do you have available for materials and possible professional services?*

About how many volunteers do you have available?

Able to provide coffee? (approx. 10:00am on Saturdays)

Yes
No

Able to provide lunch? (approx. 12:30pm on Saturdays)

Yes
No

Describe your project need and how you would like us to help. Please be as specific as possible.*

*Please note, due to the nature of volunteer work, Servant’s Heart Ministry does not take on tasks that are inherently dangerous, such as roofing or siding. For those projects, professionals will need to be hired.

Briefly describe your organization’s vision for growth, why this need is important, and what will SHM be facilitating by fulfilling this need?*

Building Information

Project Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Building Age (estimate in years)

Number of floors in the building

How long you’ve been in the building? (years)

Floors you are currently using

Choose 1:

Own
Rent
Lease
Other

Parking

Lot
Street
Driveway

Are there other tenants in the building?

Yes
No

Spots Available

Please list their names and phone numbers:

Check all the are currently functioning:

Air Filtration System
Camera or Monitoring
Central Air
Elevator
Freight Elevator
Hard Wired Fire System
Security System
Sprinklers
Water Softener

Utilities

Waste

Sewer
Septic

Energy

Electric
Solar

Water

City
Well

Heat

Natural Gas
Oil
Propane

Gas Company

Electric Company

Water Company

Other

Any construction related work in the last 3 yrs?

Yes
No

General Contractor

Electrical Contractor

Plumbing Contractor

HVAC Contractor

Are there currently any contracts on equipment?

Yes
No

Please list all contracts.

Anything else we should know about the building?

Partnership Agreement

Consent*

I agree

We understand that Servant’s Heart Ministry is a non-profit helping us renovate with a mix of skilled and unskilled volunteers. We understand that we are not hiring contractors to do a job for us, but we are partnering with Servant’s Heart to accomplish the work. Unlike contractors, Servant's Heart is not able to promise project timelines or end date, because they do not control all the variables to ensure that. We understand that this means we will need to have flexibility, ownership, and consideration in what we expect of Servant's Heart Ministry. We understand that Servant’s Heart Ministry is not obligated to purchase any material, and all material that is purchased by Servant’s Heart Ministry is expected to be reimbursed. We agree to value the project and do all we can to assist Servant's Heart Ministry in the process.

Contact Name*

Contact Signature*