Benevolent Ministry Application

The Benevolent

of Community Baptist Church of Englewood

"So then, as we have opportunity, let us do good to everyone, and especially to those who are of the household of faith." Galatians 6:10

APPLICATION FOR ASSISTANCE

NO APPLICATION WILL BE ACCEPTED IN PERSON. ALL COMPLETED APPLICATIONS NEED TO BE EMAILED OR FAX (201.983.6702) ONLY.

If you have any questions, please contact the Benevolent Ministry at 201-568-6369, ext. 214.

Community Baptist Church of Englewood

BENEVOLENT GUIDELINES

Please read each statement carefully and initial before completing and submitting this application.

1. Community Baptist Church of Englewood ("Community Baptist Church" or "CBC") offers various forms of assistance primarily to its members. Membership at CBC is defined as one having completed New Members Orientation, received the Right Hand of Fellowship and who financially supports the work of the ministry according to the Constitution and By Laws of this church. Those who have done so will have in their possession a certificate of completion, a certificate of membership and a membership identification number used when making financial contributions. (If you have questions regarding your membership, please contact the church office. The benevolent process is not the place to dispute our definition of church membership.)

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2. Non-members requesting assistance should first appeal to their home church or local agencies. In addition, non-member assistance is limited to different forms of counseling, referrals, financial coaching, mentoring and other support services with the hopes of helping you stabilize your financial situation as well as develop a healthy, biblical, financial practice for a more secure future.

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3. Community Baptist Church is not obligated to support lifestyles or decisions that are not biblical. Also, any and all support granted is designed to provide temporary assistance to help bridge the gap and is not committed to become a source of monthly or continual support. If requesting assistance, the applicant must participate in any counseling or mentoring as requested by the Benevolent Committee.

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4. If you are a member of Community Baptist Church and have received assistance in the past year, it is expected that you follow through on all recommendations from the Benevolent Committee. Please note that the responsibility to follow through on your commitments rests solely on you, the applicant. Also, if you have received assistance in the past year you are not eligible to receive assistance at this time.

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5. The Benevolent Committee reserves the right to decline assistance to any applicant.

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This is a confidential application for review by the Benevolent Committee only

Signature and Date

The Distribution of Benevolent Funds

The following stipulations pertain to the distribution of benevolent funds during the COVID- 19 Pandemic and will be adhered to impartially.

1. If you have applied for assistance within the past year you are NOT eligible to receive assistance until after the year is over. After the pandemic, the assistance will only be considered after a two-year period.

2. The Benevolence assistance covers: Rent Arrears, Utilities (PSE&G & Suez Water), and limited medical prescriptions.

3.The Benevolence assistance does not cover: Security Deposit, First Month Rent, Storage Fees, Funeral Cost, Tuition, Car Insurance/Payments, Give Cash/Loans to an applicant, and Credit Card Payments.

4. A genuine need must exist in order to receive benevolence assistance. Therefore, it is imperative that the application is completely filled out and all information is accurate and current. Any inaccurate information reported will result in an automatic denial of assistance.

5. Upon completion of application please email application and any documentation to benevolent@cbcofe.org or faxed to 201.983.6702 Attn: Benevolent Committee. All information provided in this application will be kept in strict confidence. Information will only be shared upon a need-to-know basis and with the consent of the applicant.

a. Rental Assistance

i. Lease must be in the applicant's name

ii. Applicant must provide the landlord contact information

iii. Applicant must provide the amount in arrears

b. Utilities Assistance

i. A current copy of the bill must be provided in the applicant's name

c. Prescription Assistance

i. Prescription must be in the applicant's name

ii. A copy of the prescription and the full cost of the prescription must be provided.

6. The applicant will be required to conduct a telephone interview with the Benevolent Representative to discuss the information presented on the application.

7. Please be advised that this application will be processed on the second and fourth Wednesdays of every month after submission is received by Benevolent Committee.

8. If the application is approved, all funds will be released in the form of a check made payable directly to the party (i.e. PSE&G).

9. The CBC Benevolent Ministry is not obligated to respond to last minute requests. While unforeseen circumstances arise, a lack of planning on the part of the applicant does not constitute an emergency

Acknowledgment:

I have read the above regarding the distribution of benevolent funds and I understand my obligation to be completely truthful and compliant with the process established by the CBC Benevolent Ministry.

Agreement:

I have read and understand each of the above qualifications. I understand that in submitting this application for assistance I am willing to not only allow the Community Baptist Church to assist me in this short-term resolution, and I also agree to follow through with long term guidance to bring ultimate resolution to my present situation.

Signature

Clear

Date

Your Name

Are You A Member of CBC

Date of Birth

Date

Address

Apt.

City

State

Zip Code

Home Phone

Cell Phone

Work Phone

Other

Email

example@example.com

Marital Status/Family Information

Spouse's Name

Single

DivorcedSpouse's Name:SeparatedWidowed/Widower

Number of dependent children in the home

Please provide the names and ages of all dependent children

Age

Benevolent Ministry of Community Baptist Church of Englewood

What is your hardship and how would you like the Benevolent Ministry to assist you?

What is the total amount being requested?

What events prompted your need for assistance?

What other resources have you contacted?

Have you applied for or received assistance from CBC in the past year?

YesNo

If yes, when?

Amount of assistance received

If you have applied for assistance within the past year you are not eligible to receive assistance.

If approved, to whom should the check be made payable?

Please provide a contact phone number for the entity receiving the check

Please provide documentation (proof of address, past due invoices, court orders, etc.)

Current Monthly Income

Current Employer/s

Status

Fulltime: Hrs./Week

Part Time: Hrs./Week

Hrs./Week

Benevolent Ministry of Community Baptist Church of Englewood

Other Sources of Income for the Household

Do you have any other sources of financial support?

YesNo

Sources of financial support (If yes, check all that apply)

Please provide two personal references for us to contact. Note: This is required. Please make sure you receive consent from your references.

1) Name

Phone

Relationship

How long have you known him/her?

Is he/she a member of Community Baptist Church?

YesNo

2) Name

Phone

Relationship

How long have you known him/her?

Is he/she a member of Community Baptist Church?

YesNo

Benevolent Ministry of Community Baptist Church of Englewood

For Internal Use by the CBC Benevolent Committee

Current assistance to be given

Make referral to:Issue food card(s) for $:Issue check for $:

Current assistance to be given

Make Check payable to

Action Required

Meet with a counselor regarding:

Processed by

Date

Benevolent Ministry of Community Baptist Church of Englewood