MinistryFocus Application

Application for Loan Repayment Assistance
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Vocation*
Marital Status*

SingleMarriedOther
Spouse Name
Do you have children?*

YesNo
List your child's name(s) and age(s)

Debt Information

Enter information regarding your debt.

Student Loans

	Original Amount ($)	Current Amount ($)	Monthly Payment ($)
Undergrad
Graduate
Other
Total

Are you current in your payments?

YesNo
What is the amount due?
Number of days past due?

Other Debt

	Type	Original Amount ($)	Current Amount ($)	Monthly Payment ($)
1
2
3
4
5
Total

Include auto loans, personal loans, credit cards, spouse's student loans, etc. Do not include mortage.

Asset Information

Enter information regarding your assets.
What is your current housing situation?

ParsonageRentingOwnOther
Value of home($)
Mortgage Amount($)
Net($)

Liquid Assets

	Type	Current Value ($)
1
2
3
4
5
Total

List any accounts for checking, savings, retirement, securities, etc.

Your (applicant's) Income Information

	Source	$/month
Applicant's Salary
Applicant's housing allowance
Total

Other Income Information

	Source	$/month
1
2
3
4
5
Total

Other Information

List any personal financial management course(s) you have taken/will take:

	Course	Date Completed
1
2
3
4

As a household, you prepare and monitor a family budget.

YesNo
Your District President is aware that you are seeking this assistance.

YesNo
MinistryFocus may contact your District President regarding this application.

YesNo

Information about your current ministry
Name of Congregation/School/Ministry
Address of Congregation/School/Ministry

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
LCMS District*
My congregation/School/Ministry is aware that I am seeking this assistance

YesNo
Name of Congregation/School/Ministry representative

First NameLast Name

Personal Essay

As an attachment, please share why you are applying for a MinistryFOCUS LRAP grant and how receiving such a grant will impact your ministry.
Upload Personal Essay

Cancelof

Verify and Sign
By signing this application you attest that all information included in this application is true to the best of your knowledge and verify that your serve as a called worder of the Lutheran Church—Missouri Synod.
Applicant Signature*

Clear
Spouse Signature*

Clear
Should be Empty: