Financial Assistance Request Form

Crossway Church exists to proclaim the good news of Jesus Christ and of the forgiveness and grace that are found in Him. If you are seeking financial assistance, we want to know you so that we can care for you and so that we can help you to understand who Jesus is and how He provides for your greatest need: reconciliation with God.

Name*
First Last
Current Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Previous Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Age*
Marriage Status*
Name and location of home church:
Are you a member of above church? If so, for how long?
If you have no home church or are not a member, briefly explain why.
Current or Most Recent Employer Information
List for both you and spouse
Name of Company or business:
Work Phone
Contact Person
First Last
Name of Company or business:
Work Phone
Contact Person
First Last
If currently unemployed, check here:
- You
- Spouse
Children's names & ages of only those who are currently living with you daily*
Exactly what kind of help are you asking for?*
Briefly explain the circumstances which brought about this need.*
Where else have you gone for financial assistance in the last year? How much support did each one give?*
Are you or your spouse's parents still living? If so, provide contact information:*
What type of financial aid may you be receiving from a government agency:
- Unemployment
- Social Security
- Worker's Comp
- Disability
- Other
If other, please explain
Are you willing to confidentially meet with a Deacon who may ask other and personal financial questions?*
Please type your name below as an e-signature giving your permission to have the appropriate church personnel validate any of the above information
Crossway Church makes no promise of privacy regarding any information disclosed on this form, and may report any suspected illegal behaviors to the appropriate authorities.
Comments
This field is for validation purposes and should be left unchanged.

Financial Assistance Request Form

Financial Assistance Request Form

For I Decided to Know Nothing Among You
Except Jesus Christ and Him Crucified

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