Tree of Life Ministry
140 S. Roosevelt Street, Mission, SD 57555-0149
Telephone: 605-856-4266 E-mail:
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Initial Application: Mission Work Team
Church/Organization/School ______
Address: ______
Contact Person: ______
Complete Address: ______
E-mail address: ______
Telephone Numbers: (home)______(work) ______(cell) ______
Which is your site preference? ( ) Rosebud ( ) Crow Creek
What is your choice of dates? (1st choice) ______(2nd choice) ______
Group Size: _____ youth ages 14-18 / _____ adults / ______Total
· Please confirm the number attending at least 2 weeks before arriving. Thank you.
· Note: Safety restrictions are in place for children under 14 years of age. They must have sufficient
adult supervision, may not travel to a work site, nor can they use power tools.
Interest in Cultural Events? ( ) Lakota Spirituality / ( ) Reservation Politics / ( ) Lakota Culture /
( ) Traditional Dancing / ( ) Youth Issues / ( ) Beading Class / ( ) Other: ______
Interest in Work Projects? ( ) Construction & remodeling / ( ) Conducting a VBS / ( ) A Retreat /
( ) Working with Children / ( ) Thrift Shop / ( ) Sewing / ( ) Medical: nursing/MD/dental /
( ) Other: ______
Special Skills? If anyone in your groups has special skills (roofing, plumbing, electrical, etc.) please list:
Has your group participated in any other such mission work projects? ( ) yes / ( ) no
If yes, please list the dates, sites and projects:
Note for Work Teams: Please return this completed application with the $200 application fee. We cannot
accept the application, or hold a date without this fee. The application fee is your security deposit.
------Tree of Life - Office Use Only ------Tree of Life - Office Use Only ------Tree of Life - Office Use Only ------
Deposit Confirmation and Reminder of First Payment Second Payment Final Payment
Received Partner notice sent Payment Due Received Received Received
Date Date Date Date Date Date
Amt. Amt. Amt. Amt.
Ck. # Ck. # Ck. # Ck. #
(Revised 3/4/2009)