Cornerstone Community Church Benevolence Request Form

This form is a private request for financial assistance. The deacons and elders will review your request and reply with in 48 hours from receiving it. Please fill out this form and click submit.

Name

Address

Phone

This address will receive a confirmation email

Do you have personal relationship with Jesus Christ?

Please select all that apply.

Yes No I'd like to know more

Are you a member of Cornerstone Community Church?

Please select all that apply.

Yes No

What is your relationship to Cornerstone?

Please select all that apply.

Never Attended Visited Once Attend Sometimes Regular Attender

In your opinion which best describes your financial situation?

Please select all that apply.

Short term emergency Short term problem Long term problem

What is the total amount you need help with?

What is it for?

Who should we make the check payable to:

Attach Receipt or Invoice

Upload (8MB)

Tell us a little about yourself

Are you interested in receiving financial counseling to help get your finances under control?

Please select all that apply.

Yes No

Are you currently Married

Please select all that apply.

Yes No Separated

If married, is your spouse employed?

Please select all that apply.

Yes No Full-Time Part-Time

How many people are in your household?

Name of employer

What is your weekly income?

Briefly, explain your needs and what led you to request assistance at this time. We will be praying for you and willing to provide counsel where needed.

Please provide your full name as an electronic signature.

If married, please provide spouse's full name as an electronic signature.

Description

This form is a private request for financial assistance. The deacons and elders will review your request and reply with in 48 hours from receiving it. Please fill out this form and click submit.

Cornerstone Community Church Benevolence Request Form

Description

Please Fix the Following