Mission of Hope Resource Collection Database

You don't know how much we appreciate the outpouring of support by so many in this great time of need. It has been difficult to respond to all of the offers for help. Communication, travel and organizational structure are still very shaky here in Haiti. I've set up this form for the purpose of collecting information from those who would like to travel to our Mission or provide material relief.

Please fill in the information below to the best of your ability. PLEASE realize we are still in assessment mode and cannot receive a flood of volunteers at this time,there are still aftershocks that inhibit construction work. We will do our best to get you here as soon as your skill set can be used productively. Again, thank you so much for your willingness to help.

Pastor Lex and Renee Edme, Grand Goave Hatiti
Pastor Kevin and Tammy Groder, USA

First Name Last name
Address 1
Address 2
City ST Zip Country
Email Phone
Gender? M F Age?
Are you part of a group? Y N
Group Identifier Group Leader
Church affiliation (if any)
Available Start Date (xx/xx/xxxx)
End Date
Length of Stay
Can you secure funding for your trip? Y N If so how much approx?
Your Picture (optional but very helpful to identify you, must be JPG no larger than 300x300 pixels)

What particular skills can you offer? If medical, please note area(s) of expertise.

Additional Comments