Benevolence Request Form

Please be aware of our policies regarding benevolent gifts:

All requests must go through our church office.
We may refer you to certain local agencies which were established to help this type of need.
We may refer you to financial counseling or classes.
We do not give cash.
It may take up to 14 days to process your request.

Please answer all the questions on this form. Some are personal in nature, but the more specific you can be the easier it will be for us to evaluate your situation. As stewards of God’s resources, we are concerned with your needs.

Date

YYYY

Name

First Name

Last Name

Birth Date

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Marital Status

Do you attend West Side Community Church? If yes, how long?

How often do you attend Sunday services?

Do you attend a church other than West Side? If so, what other church?

Do you know Jesus as your Lord & Savior?

Has West Side helped you financially previously?

Are you employeed? If so, where and how long?

If married, is your spouse employed? If so, where?

Names and ages of the individuals who are living in your household:

What is your specific request for help? How much financial assistance do you need?

What is the cause of your current need?

What other organizations have you contacted in your search for assistance?

I agree to allow West Side Community Church to contact appropriate officials, forward correspondence, discuss the matter, and receive pertinent information from local, state and federal agencies as it pertains to my request for benevolence.

I AGREE

Benevolence Request Form

Please be aware of our policies regarding benevolent gifts:

All requests must go through our church office.

We may refer you to certain local agencies which were established to help this type of need.

We may refer you to financial counseling or classes.

We do not give cash.

It may take up to 14 days to process your request.

Please answer all the questions on this form. Some are personal in nature, but the more specific you can be the easier it will be for us to evaluate your situation. As stewards of God’s resources, we are concerned with your needs.