Disciples Home Missions | IDWM Interregional Fund Request Form

IDWM INTERREGIONAL FUND REQUEST FORM

INTERREGIONAL AREA (HEARTLAND, NIRF, ROSES, SERF, WWOW)

DATES OF EVENT

LOCATION OF EVENT

THEME OF EVENT

REGION TO MAKE CHECK PAYABLE TO

ADDRESS TO MAIL CHECK TO

City

State/Province

Zip/Postal

AMOUNT REQUESTED

CONTACT PERSON

First

Last

EMAIL

PHONE

DISCLOSURE

It is the policy of IDWM that the Office of Disciples Women will only give $1,000 to each Interregional Event. Funds should be requested no later than sixty (60) days prior to Interregional. Any unused funds should be returned to the Disciples Women's Office, payable to Disciples Women, P.O. Box 1986, Indianapolis, IN 46206-1986. Please note in the memo section: Interregional Name, Region, Unused Funds.