City Church Benevolence Fund Application

This form is for people who are seeking financial assistance out of the City Church Benevolence Fund.

Name*
First Last
Phone*
Email*
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- Eligible individuals must be current members of City Church. Members have signed our partnership agreement and completed our membership class. This is in order to ensure that our limited funds will be available for our members who are in need.
- Funds can be requested for rent assistance and utilities.
- Payments may only be made directly to landlords, utility companies, etc. No cash payments will be made to individuals.
- Decisions regarding financial assistance will be made on a case-by-case basis after application is complete and individuals meet in person with our financial manager.
- While we will try to be timely in our process, please understand that in order to receive all necessary information and reach a decision, we will need approximately a week to process your application.
Agreement*
- I am a current member of City Church For All Nations.
- My request is for assistance in rent or utilities.
- My request is not for assistance in rent or utilities.
- I understand that any financial assistance will be in the form of payment submission to a landlord, utility company, etc and will not be cash payment to an individual.
- I understand that completion of this form is step one in the process to apply for financial assistance. If elligible, I agree to arrange a meeting with City Church's Financial Manager, JR Wyatt, to complete this process.
- I understand that the application process may take approximately one week to be completed and for funds to be allocated.
Please specify what your request is for.*
Please explain your financial need in 200 words or less:*
Do you have a job?*
How many hours do you work each week?*
Are you currently receiving any other financial assistance?*
By checking the box below, I acknowledge that I have read and agreed to the policies set forth by City Church concerning my application for financial assistance.*
- I have read and I agree
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Phone
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City Church Benevolence Fund Application

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