Financial Hardship Form
St Sarkis Church Sacrament Fee Request
Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Parish Member
*
Please Select
Yes
No
Choose the service for which you are requesting fee waiver
*
Please Select
Baptism
Wedding
Funeral at Church
Funeral at Cemetery
Choose the planned date of the service
*
-
Day
-
Month
Year
Date
Is the service for you?
*
Please Select
Yes
No
Name of the person you are requesting the fee waiver for?
*
First Name
Last Name
What is the Date of Birth of the to-be-baptised?
*
-
Month
-
Day
Year
Date
Please state your relationship to the person you are booking the sacrament for? (e.g. child, parent)
*
Why are you submitting this form on their behalf?
*
Please explain your circumstances in the box.
*
File Upload
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Optional*: If you think there are any documents that will support your case, please upload here
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of
I certify that the above facts are true to the best of my knowledge and belief.
*
Yes
I acknowledge that shall fee waiver be granted, I will only use it for booking a sacrament for the person indicated in my explanation.
*
Yes
The trust retains the right to carry out further enquiries after booking is made shall such necessity arise. It also retains the right to cancel the waiver if newly acquired information indicates breach of terms.
*
Yes
Please verify that you are human
*
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