HEART

Health Education Africa Resource Team

P.O Box 63414- 00619 Muthaiga
Nairobi, Kenya
Phone: 512-596/7

Ministry Request Form

Host Pastor _____________________ Village Name __________________District _____________

Phone: _______________Address: ________________________________

E-Mail Address: ______________________________________________

Seminar scheduled for: October 21, 22, 2005 Friday and Saturday

Has there be a Christian based Health Seminar in your area recently? _____Who hosted it? ______
Do you see a need in your area for a multi-church/community wide health- seminar? ______

HEART is a non-denominational group that seeks to reach the village people with the prevention
message of HIV/AIDS – TB Malaria and Typhoid, plus many public health issues.

HEART hosts “Village Wide” Seminars. Are you willing to work with the Pastors in your area from all
denominations to coordinate such a Health Seminar? _________

What churches will be working with you in this out reach for health in your community? Please List: name
of church and Pastors name on the attached form. How many churches participating? _______

Please name the Chief of your area: ____________________ Please contact him and request him to attend
the meetings at least to come and greet the people. Will he be attending? ___________

Please name the District Officer of your area: ___________________ Please contact the D.O. and ask for a
meeting with a HEART representative prior to the event. Request his presence at the Friday or Saturday AM
meeting. He will be asked to greet the people. Let us know if he will be attending..

Please name the District Commissioner of your area: ___________________ Please contact the D. C. and
ask for a meeting with a HEART representative prior to the event. Request his presence at the Sat AM
meeting. He will be asked to greet the people. Let us know if he will be attending.

Please name the MP of your area: _____________________________ Would you be willing to travel to
Nairobi to meet with him along with HEART if we arrange this meeting? __________

Pastor Joseph Warware is the Kenya HEART Coordinator and will be contacting you to meet with you and
the Pastors from your community to go over the schedule and plans for HEART coming to your community.

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This will be the plan for the meetings:

Friday will be an adult health educational meeting. This includes Pastors, Community Leaders, Health
Leaders (such as clinic doctors/nurses) and all adult members of your village. Friday at lunch time we would
like to meet with the Leaders of your community – for a brief introduction and sharing time while all other
seminar participants are also having lunch. .

HEART will provide the funds for lunch for a local grown food, in corporation with the participating
churches. Please ask your community churches to provide women to cook and serve the food. Our budget for
this meeting depends on attendance but must be kept at a low reasonable price. Many communities do a rice
dish. HEART will bring the plates and spoons for the lunch along with dish soap and Jik so the dishes from
Friday can be washed and used again on Saturday.

Saturday will be a community wide event for adults, youth and children. Sound equipment is needed.
Please use equipment for one of the local churches. Churches to provide chairs/benches. Please search out
a large place to host all the adult sessions. These meeting should be held in the largest building in your
area (church, community hall etc.) There should also be a near by building for the youth and children to
be taught simultaneously with these meetings on Saturday.

Adult health teachings are to begin at 9 AM on Friday – please gather the people so we can begin on time.

Adult , Youth and Children be a morning session of 10 – 12 on Saturday and again after lunch in afternoon
from 2 – 4. Each group are to have a separate meeting place.

Do you have electricity available? _________Or do we need to bring a generator? ________________

How many do you expect to attend the Health Seminars? _____

Sunday will be services in various churches. The host church and at least three others in your are. HEART
will provide the Preachers for the Sunday morning service. Which churches will HEART Teams be
attending on Sunday morning?

1. Church ___________________________________Pastor’s Name ___________________________

2. Church ___________________________________Pastor’s Name ___________________________
3. Church ____________________________________Pastor’s Name __________________________

There will be no lunch provided on Sunday by HEART.

Promotional fliers will be provided two weeks before the event to the Host Pastor but much work needs
to be done in advance for this to be a successful outreach to your community. Remember this is not
an event for your church only but for your community. So think big!

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 HEART SEMINAR
PROPOSED BUDGET:

DATE OF SEMINAR: ____________________

HOST PASTOR _____________________________________________

FRIDAY COMMUNITY LUNCH: _____________________________

SATURDAY COMMUNITY EVENT LUNCH: _______________________

LODGING FOR HEART TEAMS

Please plan to host our teams in local homes of villages leaders or families willing to open their homes.
It is not necessary to find lodging in hotels. Please plan to host at least two HEART Team members in
each home.

HEART will provide the number of visitors traveling with us needing lodging/accommodations two weeks
before the meetings.

FOR HEARTOFFICE USE ONLY

1. Syllabus for Health Sessions ____________ Cost: ____________

2. Leadership Session Materials __________ Cost: ___________
3. Materials for Youth Meetings _________ Cost: ____________
4. Materials for Children Meetings ________ Cost: _____________
5. Materials for Marriage Session ________ Cost: _____________
6. Health Teach Aids (Soap etc.) __________ Cost: _____________
7. Promotional Materials (Fliers) ____________ Cost: ____________
8. Travel Expenses; Land Rovers: __________ Cost of Second Vehicle: __________

LIST OF CHURCHES TO ATTEND HEART SEMINAR

DATE OF SEMINAR: ____________________

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 HOST PASTOR _____________________________________________

Address: _________________________________________________________________________

POINT PERSON: _____________________________ Phone ________________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Church _____________________________________Pastor _______________________________

Community Leader __________________________________Title _______________________________

Community Leader __________________________________Title _______________________________

Community Leader __________________________________Title _______________________________

Community Leader __________________________________Title _______________________________

NOTES OR SUGGESTIONS TO MAKE THIS A SPECIAL AND SUCCESSFUL EVENT: