Southeastern District – LCMS 6315 Grovedale Drive Alexandria, VA 223102501 800.637.5723

Ablaze for God's Mission Ablaze! Circuit Mission and New Outreach Ministry Grant Request

Grant Requestor Summary

Part 1 – Requestor Information

Full name of the ministry

Contact person

Mailing address

Web site address

City, town or post office

State

ZIP code + 4

Circuit Number

Phone number and extension

Fax number

Name of the Circuit Counselor and Circuit Mission Advocate

Has a local mission committee been formed? Yes No

Part 2 – Mission Project Coordinator Information

Mission Project Coordinator

Mailing address

Street address (if different than the mailing address)

City, town or post office

State

ZIP code + 4

E-mail address

Work phone number and extension

Best time to call

Fax number

Project director signature

Date (mm/dd/yyyy)

Circuit Mission Advocate Signature

Date (mm/dd/yyyy)

Part 3 – Project Basics

Project title

Grant requested $

Total project cost $

Does this project involve starting a new mission that may evolve into a chartered LCMS congregation? Yes No

Project Start date (if applicable)

Project End date (if applicable)

Briefly describe the project. Include the vision and mission for this ministry and the mission values that are guiding the effort.

Action plan: Chronologically list the main action steps and decision points pivotal to completing the project. Outline the timeline in the two-column table below showing the corresponding actions beginning with the start date and ending with the end date.

Activities

Target Dates

Start date

1.

2.

3.

4.

5.

6.

Grant Proposal Narrative

Summary: How will peoples’ lives be transformed as a result of this project?

Type of Mission Center: Which of the following descriptor(s) best describes this outreach effort (check all that apply)?

Outreach to ethnic or immigrant group(s)

Outreach through Lutheran Education or Child Development Center

Outreach through Daughter or Satellite Church planting

Outreach to the Urban area

Outreach to people not currently being served by the congregation

Other types of outreach (please describe)

1. Outreach: As a result of this grant project, please describe and quantify the demographic group you will target through the described mission center.

What activities are you planning to help you reach this demographic group?

A.

B.

C.

How will you evaluate your activities?

A.

B.

C.

2. Mission Prayer Support: What will you do to develop a prayer team to surround this mission effort?

3. Sustainability: Describe how your project will extend beyond the life of the grant as an ongoing ministry?

Budget Information
Please provide an itemized list of funding sources (with the amount expected from each source) and anticipated project expenses. Include in-kind contributions.
Income
All Sources of Income/Revenue	Estimated Income
Ablaze! Circuit Mission and New Outreach Grant request (proposed)	$
Total estimated project income This amount must equal project expense.	$
Expenses
Project Expense Description	Estimated Expense
	$
Total estimated project expense	$
Balance (income minus expense)	$
In-Kind Support
Sources of In-Kind Support	Estimated Value
	$
Estimated project in-kind support	$