Relief Fund Purpose Statement
This relief fund is resourced by the love and generosity of our Christian family. The fund provides assistance for those directly affected by the COVID-19 pandemic by providing grocery cards to those who qualify. The goal is to help as many people in need as possible beginning with those in the greatest need. Many factors affect our ability to grant assistance and all may not qualify. Subject to funds availability. (This form has been updated, please read carefully)
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Phone Number
*
-
Area Code
Phone Number
Email
example@example.com
Are you a member of The Rock? (verifiable by our church records which means you filled out a Welcome card or gave an offering at least once)
*
Yes
No
If so, which congregation?
Anaheim English
Corona English
Hesperia
Lake Elsinore
Seal Beach English
West Anaheim English
West Anaheim Spanish
Battle Creek, MI
Kalamazoo, MI
How many adults (18 years old and older) currently live in your home?
*
How many children (0-17 years old) currently live in your home?
*
Are you or an adult in your household employed?
*
Yes
No
Has this adult's hours been reduced due to the Coronavirus restrictions?
*
Yes
No
Have you researched local/county/state assistance? (Many programs are available during this crisis.)
*
Yes
No
This relief fund is to help provide grocery cards affected by the Coronavirus situation. Tell us your story. Be as specific as you can.
*
Submit
Should be Empty: