Financial Assistance Request Form (Brief) (Page 3 of 3) in pdf

Financial Assistance Request Form (Brief) Page 3

SECTION IV

What type of assistance are you applying for?

Are you a member of this Church?

If not, how were you referred to us?

Are you receiving any aid (financial or otherwise) from a government agency

(unemployment insurance, workman’s compensation, etc.)?

Have you been employed locally?

If not employed presently, who was your last employer?

When and where was the last time you sought employment, if not presently employed?

Are you willing to work today if we know of an available job?

Are you a member of another church?

If so, where?

Have you applied for financial assistance at your church?

What is your pastor’s name?

10.

Have you sought assistance at any other churches in this area?

11.

If so, where and when?

12.

If we are unable to help you, what other options do you have?

13.

Would you be willing to meet with a financial counselor?

14.

Is there a way that this church could better meet your spiritual needs?

Please explain:

15.

In your personal opinion, who is Jesus?

16.

In your personal opinion, who is Jesus to you?

I promise that the above information is true and correct to the best of my knowledge.

__________________ Baptist Church has my permission to check any of the above information

and to use it to determine my assistance.

Signature ____________________________Date _______________________

This document is intended to provide churches, pastors, and staff with current and accurate information about the subjects covered. However,

such information is not intended to be sufficient for dealing with a particular legal problem, and the authors and distributors do not warrant or

represent its suitability for such purpose. The reader should not rely upon this document as a substitute for independent legal consultation or IRS

instructions.

1/2016

Gifts of Georgia Baptists through Mission Georgia and the Cooperative Program enable us to partner together in fulfilling the Great Commission.

Financial Assistance Request Form (Brief) Page 3