EMI Disaster Response Application Dear Brother or Sister in Christ, Thank you for your interest in Engineering Ministries International (EMI) and the disaster response services we offer. EMI is a non-profit network of engineers, architects, and surveyors who donate their design services to Christian ministries in developing countries that are helping the poor and advancing the message of hope. Applying practical design and cultural experience, EMI staff coordinate project work to develop culturally appropriate solutions. Since 1982, we have served in over 90 countries by designing over 1,200 development projects that bring the gospel of hope to those in need. In addition to our development experience, EMI has a disaster response program consisting of a preselected and trained pool of volunteer technical specialists willing to travel on short notice. Specialties include: water & sanitation, transitional shelter, structural assessment, geotechnical analysis, and facilities design. Each volunteer has prior developing world technical experience and has been pre-screened for spiritual maturity, physical fitness, and mental flexibility. Our goal is to show God's love in a practical way by providing quality assessment and technical consulting services during the critical days and weeks following a disaster. We offer our services to any organization serving the poor in Jesus' name. See http://emiworld.org/disasterresponse_main.php for more information We generally require the host ministry to provide the in-country needs of our response team (2 to 6 people) during their time on site: basic meals, in-country transportation, and security (if necessary). In addition, we also ask you to donate the cost of the team’s airfare to the project site, as well as a donation to EMI to cover our administrative costs. Please let me know if you have any questions. You may reach me at justin.rolfs@emiusa.org or disasters@emiworld.org or (719) 633-2078 x104. I look forward to the possibility of serving the Lord with you! In His Service, Justin Rolfs Disaster Response Coordinator, EMI USA P.S. If you seek help with a development project, please send an email to projects@emiworld.org. We Believe… In the verbal inspiration of the Bible. In one God manifested in three persons. Man is created in the image of God, fallen through Adam’s sin, redeemed only through the saving work of Jesus Christ. In the pre-existence of Christ, His virgin birth, His vicarious death on the cross, His resurrection and His second coming. In the person of the Holy Spirit, His convicting, regenerating, baptizing, sealing, indwelling, teaching and filling ministries. EMI Disaster Response Application Application Information 1. General: Organization name: Location of response: Your name: Name of other partnering organizations (if any): 2. International office contact (home office): Name: E-Mail: Office Phone: Mobile Phone: Address: Country: 3. Local field contact at response site: Name: E-Mail: Office Phone: Mobile Phone: 4. Please provide a brief description of your response efforts: 5. Please provide GPS coordinates of the location of your project: 6. What response services from EMI do you require? (Click on box to check) Disaster assessment Water supply and/or distribution Structural assessment Wastewater/sanitation Geotechnical analysis/shoring Surface rain water/drainage Transitional shelter design Facilities design Other: 7. In what specific way(s) can EMI support you with volunteer technical specialists? 8. A typical EMI disaster response team consists of 2 to 6 people, but can be more. What is the maximum number of design professionals you can accommodate? 9. What living conditions do you anticipate for potential team members? Page 1 10. Please provide any further information you have that would help EMI recruit a team specifically tailored to your response needs: 11. When would you ideally like to have an EMI team on the ground working on your project? Are these dates flexible at all? Signature: By signing below, I agree that… I have read and understand EMI’s positions, policies, and requests as set forth in this application. Our ministry will provide on-site expenses for a potential team as described in this application. Our ministry will provide reimbursement for the team’s airfare as described in this application. If not possible, please provide justification for why. I have completely filled out the application. All statements are true to the best of my knowledge. Ministry Director’s Name (please print) Signature / Date 12. Do you have a Memorandum of Understanding (MOU) with EMI? 13. Have you hosted an EMI team on a previous project? Project: Date: EMI project leader: Yes Yes, attached No MOU exists. No. If yes, please identify: *** PLEASE FILL OUT THE FOLLOWING INFORMATION ONLY IF YOU CHECKED “NO” TO BOTH ITEMS 12 and 13 ABOVE *** Additional Information 14. Board member, elder, overseer contact Name: E-Mail: Office Phone: Mobile Phone: Address: 15. Reference person (someone outside of your ministry, who can recommend you and your ministry) Name: E-Mail: Office Phone: Mobile Phone: Address: Page 2 16. Ministry Background A. Purpose: B. History: C. Statement of Belief: D. Organizational Structure: 17. Funding EMI invests a great deal of time and effort into assisting your relief efforts and we want to see them be successful. Knowing your financial standing and funding strategies will help us understand the best approach to take. Project needs can be suitably provided for whether the project designed by EMI is an expensive solution or an inexpensive solution. EMI will always strive to provide a financially appropriate project solution. A. Project Cost What do you think this response effort will cost? $ B. Relief Funding, including amounts and timing. Current finances in possession for project: $ What is your funding strategy and timing? (Check all that apply with approximate dates and dollar amounts) Government Grants: $ by this date: Private Grants: $ by this date: Donors: $ by this date: Loan: $ by this date: Other: $ by this date: Page 3