Fellowship Fund Financial Assistance Application

Fellowship Fund Financial Assistance Application
Name of Applicant*

First NameLast Name
Email Address*
Phone Number*

Area CodePhone Number
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of Birth*

MonthDayYear
Marital Status
Current Employer*
Annual Salary*
Do you attend Ocean City Church?*
Do you attend another church?
If you do attend another church, where? Have you requested their assistance? What has been their response?
Have you previously received financial assistance from Ocean City Church?*
Total Amount of Your Request*
Due Date*

MonthDayYear
Date
Please explain your need and the circumstances surrounding your situation. *
What steps have been taken to obtain assistance from other sources?*
What additional long-term assistance (spiritual, financial, family counseling, vocational training, etc.) would help you in resolving this issue in the future?*
If assistance is approved, to whom should we send a check? (Please be sure to attach copy of bill or statement below.)
Payee Name:*
Mailing Address: *

Street Address

Street Address Line 2

CityState

Zip Code
Please use the "Upload a File" button below to upload supporting documentation, such as: lease agreement, mortgage, utility bill, etc. Your application may be denied without supporting documents.

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