Benevolence Request Form

Form Contact

I'm Filling This Form Out For...

Name

This address will receive a confirmation email

Phone

Address [skip if you're filling this form out for someone else]

Relationship To Renovation Church

Benevolence Contact

Skip if you're filling this out for yourself.

Name

Phone

Address

Benevolence Details

Primary Reasons Funds Are Needed

Monetary Needs For [check all that apply]

Rent/Mortgage Food Basic Utilities Transportation Medical Other

If "Other" Was Checked Please Explain

Total Amount Requested [can be a range if exact amount needed is unknown]

Date Needed By

Funds Directed To [NOTE: It cannot be you]

Contact Name

Contact Number

Funds Mailed To

Description

If you or someone you know are in need of financial help during a difficult time, please fill this form out completely and one of our Deacons will followup with you. If you are filling this out for someone else, please be sure that person is aware that you are filling out this form and they have expressed a desire for help.

Please know our policies restrict us from designating funds to you, or the person for which you are filling out this form. Funds must be directed to a company or person (ie. landlord) in order to be considered for approval.

Benevolence Request Form

Description

Please Fix the Following