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Benevolence Request

Please attempt to answer all questions on this form. While we realize that many are personal in nature, the more specific you can be, the easier it will be for us to evaluate your situation. Also, so that we may be good stewards of God’s resources and to prevent fraud, please be aware that we reserve the right to contact anyone referenced below to confirm the information given on this form.

Status
Membership Status
Are you considered a tither?
Did you ask or did your church offer financial assistance?
Have you sought assistance from any other churches?
Have you sought or received assistance from any other agencies?
If we can't provide assistance, do you have other options?
If unemployed, are you looking for work?
Special Assistance? If Yes, check all that apply.
By checking the agree box, you agree that all the information you have provided is true and correct and that we have the right to verify. Also by checking I Agree you understand that this is an electronic signature.
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