CLF Benevolence Application

Please fill out this form and click submit.

Date

Name

This address will receive a confirmation email

Phone

Address

Status of applicant

Please select all that apply.

Member Attender Other

Which Community Group (if applicable) are you/they in?

Do you/they have and follow a budget?

Please select one option.

Yes No

Personal Budget Attached?

Please select one option.

Yes No

Have you/they taken the Financial Peace Class?

Please select one option.

Yes No

Are you/they willing to receive financial counseling?

Please select one option.

Yes No

Amount Requested:

What will the funds be used for?

Specific details pertaining to how and why this need developed:

What other resources are available (family, savings)?

-------------------- FOR OFFICE USE ONLY --------------------

Have they been faithfully tithing/giving to the church in the past year?

Please select one option.

Yes No

Date of last financial gift to CLF:

Do they have a budget they are faithfully using?

Please select one option.

Yes No

Have they received benevolence previously?

Please select one option.

Yes No

If yes, when?

How much?

Has their CG been asked to help with the need?

Please select one option.

Yes No

If Yes, how much was given?

Notes/Comments:

Approved amount:

For checks, who is the recipient:

For gift cards, which business:

Signature of Benevolence Committee Chair:

_____________________________________________________

Signature of two elders (Elders required to approve if a single gift over $1,500.00 or ongoing gift over $3,000.00).

Signature of Elder:____________________________________

Signature of Elder:____________________________________

Description

Please fill out this form and click submit.

CLF Benevolence Application

Description

Please Fix the Following