Deacon’s Fund

Applicant Information

First Name

Last Name

Email

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Statement of Need

Briefly describe your need, situation, amount of financial assistance requested, and duration of need

Previous Requests

Have you requested assistance from this fund or from other churches in the past?

If deemed necessary, are you willing to attend Church-sponsored financial training?

If this request is for $500 or more, please continue the form below

Summary of Financial Status

Household Monthly Income

$

Total Current Assets (cash, checking accounts, savings accounts, investments, other current assets)

$

Total Monthly Debt Obligations

$

What options, if any, are available to you for support/assistance?

What type of assistance, if any, do you currently receive?

What other information would you like to communicate to the Deacons for consideration?

“Love bears all things, believes all things, hopes all things, endures all things”

— 1 Corinthians 13:7