MCC Financial AID Request Form
Name
*
First Name
Last Name
Phone Number
-
Area Code
Phone Number
What is your Email Address
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What kind of AID can we help you with
*
Financial
Food
How many live in your home?
*
How long have you been a Member or attending MCC?
*
What has happened that has recently created this financial strain for you and your family?
What specifically are you in need of and requesting ? (Be specific).
*
Have you requested assistance from another Church/Organization/Government ?
*
Select
Yes
No
If you have requested assistance who have you reached out to?
Is there a Pastoral reference who can verify that you are an active participant at MCC?
Yes
No
If so, who is that? ____________________________(This will be used to verify your information).
Name of Pastoral Reference
Please leave us your best contact info that you prefer to use: phone/text/email ?
*
Phone
Text
Email
We will do our very best to assist you at, at some level, in your time of need. Thanks
Pastor Craig will be in touch with you, within 48 hours.
Submit
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