Benevolent Assistance Request Form printable pdf download

BENEVOLENT ASSISTANCE REQUEST FORM

Monies are collected annually which are intended to provide financial assistance to Richmond Christian

School community members who have an extraordinary need.

To request financial support from the Richmond Christian School Benevolent Fund, the applicant must

be a Richmond Christian School staff member, Society member or parent of a current student. The

submission of a request cannot be anonymous as additional information may be critical to ensure that

the need is properly met. All requests will be handled with strict confidentiality.

Please complete this form and provide it to the current Chair of the Board of Trustees in a sealed

envelope marked “Strictly Confidential.” The form may be emailed to the Chair whose email is available

on the school website.

FULL NAME OF STUDENT OR FAMILY IN NEED: ____________________________________________

DATES THE FUNDS ARE NEEDED BY: ________________________________ (MM/DD/YY)

AMOUNT OF FUNDS REQUESTED: __________________________________

IS THIS A ONE TIME OR ONGOING NEED? ____________________________

PLEASE EXPLAIN WHY YOU BELIEVE THAT THIS STUDENT/FAMILY REQUIRES THIS SUPPORT:

_____________________________________________________________________________________

________________________________________

________________________________

YOUR NAME

DATE

The parties identified on this application form will be kept confidential. Please deliver or mail this form to any

campus office, Attn. Chair of the Board of Trustees, or email the completed form to the Chair whose RCS email

address is available on the school website.

For internal use:

For

Request Approval: Yes / No

Amount Approved $ ____________ Date: ________________

Approved by: _____________________ (Board Chair / Vice Chair) Name: _____________________

Benevolent Assistance Request Form