Application for Assistance

Please take a minute to do your best to fill out this form completely. It will help our deacons decide if we are able to assist you at this time. You can expect a response within two weeks. Please do not fill out multiple forms.

Grace Church is not an emergency assistance organization. We are a church. Our primary goal is to spread the Good News of the one who died and rose to meets our soul's deepest needs, Jesus Christ. He shared himself with us, and we desire to share His mercy with others.

Our deacons consider each application for assistance individually, and in some cases we may determine that our church is not the best entity to meet a need.
Per our policy, we meet in person with each applicant prior to providing any assistance, to assess the state of their physical and spiritual needs and to establish a relationship. Because the deacons' first priority is to serve the needs of our own church body, we cannot respond instantaneously to applications.
Our desire is to build long-term relationships in the context of our church, and to welcome people into our church, where all aspects of their needs can be best met.
Please note, we do not give cash under any circumstances. In most cases, we will pay directly to the person or organization to which you owe money.

By submitting this form, you give permission for Grace Church to exchange this information with necessary parties, including prescribing physicians if this request is for assistance with medical needs. This form is not a contract and submitting it is not a guarantee that we will be able to provide aid.

Your name *

Email address *

Phone number

Address

Does Anyone Else Live In Your Home? *

Please explain your need and now Grace Church can help you *

How did you hear about Grace Church? *

Employment Info

Are you currently employed? *

What is your weekly income? *

min: 0

What is your monthly rent/mortgage? *

min: 0

Are you disabled?

Does anyone else in your household receive regular financial assistance (child support, food stamps, social security, etc.)? *

Have you received any financial assistance from other sources in the area in the past 6 monts (other churches, RAM house, TAAP, etc.)? *

Do you attend church? *

Are you willing and able to help us by working on our church grounds? *

What's your relationship with Jesus Christ?

References

Reference 1 Name *

Reference 1 Phone Number *

Reference 2 Name *

Reference 2 Phone Number *

Associated documents (optional)

Include any relevant bills or notices, etc. for your need if you can. This will help expedite our review of your request.

No files currently selected

Add up to 5 files. Maximum file size 10 MB.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.