REQUEST FOR AID

REQUEST FOR AID

Old River Baptist Church has a benevolence ministry that may be able to assist with emergency financial needs for individuals who live within five miles of our church or who are members of our church. The first step is to complete a Financial Assistance Request Form. Once we receive your completed form, our benevolence team will review your request. Please know that submitting an application does not guarantee assistance, but every request is carefully considered based on the circumstances and our available resources.If this is your second request for assistance, we’ll also schedule a meeting with one of our financial counselors before any additional assistance can be considered. That meeting gives us an opportunity to better understand your situation, pray with you, and explore ways we can help beyond the immediate need.If you’re outside our service area, we’d be happy to help connect you with a church or organization that may be able to serve you where you live.
Name
Phone
Format: (000) 000-0000.
Address

Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Permanent Address
Date of Birth
ORBC Church Membership
If not, where do you attend church
Employed by
How Long
Drivers Lic
LIST EACH FAMILY MEMBER LIVING IN YOUR HOUSEHOLD AND THEIR AGE:
Name
Relationship
Age
Name
Relationship
Age
Name
Relationship
Age
Name
Relationship
Age
Name
Relationship
Age
Name
Relationship
Age
Name
Relationship
Age
Name
Relationship
Age
Who referred you to this ORBC
Type of Aid Requested
When and where did you last receive help
What Aid are you getting now? Food Stamps
Food Stamps
AFDC
SSI
Rent Supplement (HUD)
Free School Lunches
Has our Church Helped you before
When
IHAVE ANSWERED ALL THE QUESTIONS TRUTHFULLY AND HONESTLY.
SIGNATURE
Should be Empty: