2023 Financial Assistance Application Form

2023 Financial Assistance Application Form

Rainbow Valley Resource Network's mission is to build compassionate community and support for Christian Scientists with developmental/special needs and their families through financial assistance, informational and inspirational resources, and experiential enrichment activities. We believe that God’s love is universal, and no one should feel outside of His care.
We are pleased to offer financial assistance for the following types of support:
- Supplying subscriptions to Christian Science periodicals
- Assisting with Christian Science practitioner and nurse bills
- Making financial assistance available for respite and enrichment activities (such as tuition for an individual and chaperone to attend experiential programs for Christian Scientists)
If assistance is granted we ask recipients to complete an Acknowledgement of Funds form, which includes the opportunity to share how the assistance blessed the individual.

Information for the individual needing assistance:
What is the name of the individual needing financial assistance?*

First NameLast Name
What is their address (if different from the requester)?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Financial Assistance Request

Rainbow Valley Resource Network provides financial assistance for services that support the spiritual growth and progress of individuals with developmental/special needs through the study of Christian Science.
Based on the type of activities RVRN supports as described at the top of this form, please share the intended use of the funds you are requesting and how the activity will support the spiritual growth and/or further the individual’s understanding of Christian Science. *
What is the estimated total cost of the activity/service? *
What portion of the overall costs are you able to contribute?*
What is the amount you are requesting from RVRN?*
Date funds are needed*

MonthDayYear
Date
Have you sought other sources of assistance? If so, which?*
Is there any other information you would like us to consider?*
Who or how were you referred to RVRN? *

Requester Information