Contact Siloam Missionary Homes

For accommodation request, please fill out our online application form below

Title

First Name

Middle Name

Last Name

Gender

Correspondence Address

Phone

Email Address

Present Status

(check one)

	Regular missionaries on regular or medical furlough
	Retiring foreign missionaries who have just completed their life-time service
	Home missionaries on regular or medical furlough
	Approved missionary appointees on deputation work
	Other Christian workers with fundamental, established Christian organizations
	Retired missionaries or retired Christian workers

Field of Service

Years of Service

Give a brief account of
your conversion

Give a brief resume of your
ministry experience

When did you arrive
from the field?

When do you plan to return?

Home Church

Home Church Address

Education (fill out all that apply)

Bible School

College

Seminary

Are you an R.N.?

Yes No

Are you a Practical Nurse?

Yes No

Mission Board Information

Mission Board

Address

Phone

Group Applicant Information

Number of Applicants

Single

Yes No

Husband's Name

Birthdate

Wife's Name

Birthdate

Children

Birthdate

Date Accommodations Desired

Arrival

Departure

Have you been
our guest(s) before?

Yes No

Emergency Contact in the U.S.

Relationship

Address

Phone

How did you hear about
Siloam Missionary Homes?

We have carefully read the Policies & Procedures and Doctrinal Statement
of Siloam Missionary Homes, and we agree to willingly and conscientiously accept them and will abide by them.

I Agree I Disagree

THIS APPLICATION WILL NOT RESULT IN A CONFIRMED RESERVATION UNTIL A NON-REFUNDABLE RESERVATION DEPOSIT OF U.S. $200 HAS BEEN RECEIVED BY SILOAM MISSIONARY HOMES.
Note regarding deposit: This deposit will be refunded 60 days from departure date, less any outstanding telephone and electric charges, damage to the duplex (other than normal wear & tear), cleaning or rubbish removal.

Contact Information

PO Box 705
1053 Quakenbush Road
Snow Camp, NC 27349

Office: 336-376-8200
Toll Free: 877-914-3721
Fax: 336-376-8744
Email: joyce@siloamhomes.org

Contact Form