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		PACIFIC SOUTHWEST DISTRICT
		LUTHERAN WOMEN IN MISSION
			SPECIAL GIFT FUND
Mission Statement:  Provide financial assistance to women of the Lutheran Women's Missionary 
League (LWML) seeking to serve in areas where God leads them in their locals, zones, Pacific Southwest 
District and LWML.  The specific intent of this fund to assist those who otherwise find the financial 
requirement burden prohibitive.
			REQUEST FOR FUNDS
Name, Address and Phone Number of applicant:

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Home Congregation:  __________________________________________________________
			
Address: 	_________________________________________________________________		
Amount Allotted:      $150.		Date of request: _________________________		
Describe the event/program for which funds are requested:

PSWD Convention - June 9-11, 2006 - Cathedral City, CA
Answer the following questions on the back of this application:
1. What is your participation in LWML?
2. What do you hope for the future for LWML?
3. What is your participation in your church?
4. What role do you see for yourself in future ministry?
In return for grant, if approved, you will be asked to promote the goals of LWML
				Submitted:  ______________________________		
				                     Signature of applicant
Approval: ___________________________	Approval:  _______________________________		
                  Local Mentor                                                 Local Pastor
Local Mentor:  _________________________________________________________________				
                                    Name, address, phone #
(Mentor is to assist applicant with attendance information and be a contact person for the committee.)
Return before February 28, 2006 to:	Barbara Carter
				1352 W. Princeton St.
				Ontario, CA 91762-1727