Helps Fund

The purpose of the Helps Fund is to provide assistance for basic needs. This fund is not applicable for cases in which long-term financial support is needed. The entire form must be completed to be considered for assistance.

By filling out the form below, you give consent for your information to be reviewed by the Pastor and official board of Grace Assembly. Applicants are not guaranteed financial assistance upon completion of this form. Grace Assembly has the right to adjust or decline an applicant's request, and may consider providing assistance other than monetary help.

Your name *

Last name

Email address *

Address *

Country

Street address

Apt/unit/box (optional)

City

State

Postal code

Phone number *

Phone type

Marital status

Household members

Are you currently employed? If so, where? And for how long?

Explanation of Need

Funds needed for the payment of:

Mortgage/Rent

Utilities

Medical Expenses

Food

Transportation

Other

Please describe in detail the circumstances that prompted you to seek help from the church.

Amount requested:

Date funds are needed:

What steps have been taken to obtain financial assistance from non-church sources?

Have you been in contact with community resources?
Are you currently seeking additional employment opportunities?
Have you sought out help from other sources?

How will you meet this financial obligation going forward?

General Information

Do you attend Grace Assembly?

Yes, regularly.

Sometimes.

I've come once.

No, I've never been.

If Grace Assembly is not your home church, what is your home church?

I give permission for my information to be reviewed by the pastors and official board of Grace Assembly.

I understand that it is the church's preference to pay directly to the creditor.

Have you received financial assistance from Grace Assembly in the last 12 months?

Yes

I understand that Grace Assembly has the right to adjust or decline this request.

I have filled out this form in honesty and transparency. Any violation of honesty will disqualify the request.

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Grace Assembly of God
office@graceagpa.org
610-495-5270

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