Benevolence Form Application
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Thank you for considering the Life Link Church family in your Benevolence Request. Life Link Church is
committed to help strengthen people through a variety of means, one of which is through extending
financial benevolence to those who are within the guidelines and scope that our Benevolence Ministry is
designed to assist (i.e. active members of the Life Link Church Family). We want you to know that we
prayerfully consider each request individually and look forward to being a part of God’s plan for you in
some way. If we are unable to assist you with this request, we are happy to provide information on
additional resources that may be able to help.
Please review the Life Link Church Benevolence Guidelines to verify your eligibility before
completing and submitting this request form.
PERSONAL INFORMATION
Person requesting the funds: __________________________________________
Address: ___________________________________________ City: _____________
Zip Code: ___________
Your best Phone number: (____)________________
Place of Employment: ___________________________________________
Address: _____________________________________________________
Business Phone: (_____)_____________ Contact Person: ______________
MEMBERSHIP, ATTENDANCE & ACTIVE PARTICIPATION INFORMATION
Life Link Church Member: (circle one) YES NO
Membership Class and Signed Membership Commitment:
(approximate month/year) ____ / _____
Worship services attended within the last 12 weeks? __________
Where do you serve at Life Link Church? ______________________________________
Which Life Group are you currently in? _______________________________________
Name of current Life Group Leader: _________________________________________
BENEVOLENCE INFORMATION
Previously had assistance: (circle one) YES NO For what: ________________________
Last Date of Assistance: ________________________ How much $________________
Description of Need: _____________________________________________________
Bill you are requesting assistance with: ______________________________________
Bill is payable to: ________________________________________________________
Address: _____________________________ City _____________ St ____ Zip ______
Account Number: _______________________________ Amount: $_______________
Description of Bill: ______________________________________________________
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(Departmental Use – DO NOT WRITE BELOW THIS LINE)
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Check Mailed/Credit Card Payment Made: _____________________________________
(date/amount)
Approved by: _________________________________ ________________________
(Financial Team)
(Pastoral Signature)
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Parent category: Financial