1. Please complete the entire application as all fields are required.
Donor Information
  1.  *
  2.  *
  3.  *
  4.  *
  5.  (valid email required)
Location Information
  1.  *

  2.  *
  3.  *
  4. Select all of the following that are available at your location.
  5. Facilities

  6. Local Contact Person (if any)
  7. Do you have a phone at your host property? (Leave blank if no)
  8.  *
  9. Alcoholic drinks, smoking, drugs, and all forms of adult-related material and pornography are prohibited by Pastors R&R.
  1. Do you carry casualty and general liability insurance for your property?

  2. If yes, please provide us with a copy of your policy’s face sheet. All hosts must maintain casualty and general liabilty insurance and agree to hold harmless Pastors R&R for any and all damages caused for any reason whatsoever by guests.
Special Request
  1. Please submit 2 interior and 2 exterior pictures plus an area map of your host property.
  1. By entering my name below, I hereby declare that all of the information I have provided in this application is true and accurate to the best of my knowledge.
  2.  *