Home
Plan A Visit
Connect
About Us
Our Team
Events
Serve
AppGen
AppGroups
Vertical
Women's Ministry
Men's Ministry
Missions
AppResidency
Give
Prayer
Sermons
Resources
Resources For You
Ministry Leader Resources
Assistance
Need Assistance?
If you're needing assistance with your home, bills or food please let us know by filling out the form below! We want to be a support resource for our community, and this information is the first step to allowing us to help you.
First Name
Last Name
Phone Number
Address
Apartment, suite, etc.
City
State
Zip/Postal Code
Email
Name of member(s) or regular attender(s) of Appalachian Church recommending you for assistance: Include their phone numbers.
Name two persons, not related to you, able to verify your circumstance. Include their phone numbers.
Names of Social Worker(s) that are familiar with your circumstances, not related to you
Why do you need assitance?
Name of your employer, their address and phone number
Submitting this form does not gurantee assistance will be granted. Names of anyone in your home over the age of 18
I also understand that benevolence from this church is a one-time gift and I cannot re-apply for another request for a period of one (1) year. I give Appalachian Church permission to verify any information given on this request for assistance, unless I have noted otherwise, in writing, on this form. Verification of information may include correspondence, phone calls or visits.
Signature
Submitting this form does not guarantee assistance will be granted.
The Benevolence Coordinator solely determines granting and amount of assistance.
Incomplete forms will not be considered.
Dishonesty of any kind on this application will result in denial of assistance.
Your signature on this documents grants Appalachian Church permission to verify your
information as it deems necessary.
We MUST have a photo of your current photo ID and a copy of everyone over 18 living in your household to be considered for urgent assistance. If you have any problems with this form, send the photo to our church office at Appalachianchurch@gmail.com along with your form submission.
<
Back
Next
>
Submit
