CARE FOR OUR NEIGHBORS

Let’s take the
next step together.

If you’re facing a difficult season, tell us how we may be able to help. Start with a benevolence request.

Faith Community UMC Benevolence Support Application

Fields marked * are required.

Please Note: Must Live in Greene County. We can only help with Rent, Water, Gas or Electric Payments

Name

First Name *

Last Name *

Age *

Accepts only numbers and period

Add Name of All in the Household 1

First Name *

Last Name *

Address

Address Line 1 *

Address Line 2 (optional)

City *

State *

Country *

Zip Code *

Phone Number (optional)

Email *

How did you find our church/were you referred by someone/place? *

Church Affiliation (optional)

Church Member * Yes No

What Hardship have you experienced making it difficult to pay your bills. Please be as specific as possible as to what happened and when. *

Explain your specific financial need/request in detail, please include total amount owed and if anyone else has pledged any amount: *

Amount Requested: *

Accepts only numbers and period

Date Needed By: *

Utilities Aid Requests, Account Number: (YOU MUST PROVIDE VALID ACCOUNT NUMBER) (optional)

Rental Payments, Landlord's Name: (YOU MUST PROVIDE VALID LANDLORD'S NAME AND PHONE NUMBER) (optional)

Landlord's Phone Number (optional)

Connecting to the request form…