International

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

What are the greatest needs of your community *

	1	2	3	4	5	6
Health	1Health 1	2Health 2	3Health 3	4Health 4	5Health 5	6Health 6
Food	1Food 1	2Food 2	3Food 3	4Food 4	5Food 5	6Food 6
Housing	1Housing 1	2Housing 2	3Housing 3	4Housing 4	5Housing 5	6Housing 6
Education	1Education 1	2Education 2	3Education 3	4Education 4	5Education 5	6Education 6
Work	1Work 1	2Work 2	3Work 3	4Work 4	5Work 5	6Work 6
Environmental Health	1Environmental Health 1	2Environmental Health 2	3Environmental Health 3	4Environmental Health 4	5Environmental Health 5	6Environmental Health 6
Child Care	1Child Care 1	2Child Care 2	3Child Care 3	4Child Care 4	5Child Care 5	6Child Care 6

Select according to the need of your community, understanding 1 for the highest priority and 6 for the lowest priority.

What are the strengths of your community *

What resources have already been identified in your community *

What are the main problems and challenges for your church to grow as a church to do integral work: *

Select according to the main problems and challenges of your church, understanding 1 for the highest priority and 5 for the lowest priority.

Which are the highest priority partnerships: *

Select according to the highest priority of your church, understanding 1 for the highest priority and 4 for the lowest priority.

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