Church Assistance Request Form
Clareview Ward | The Church of Jesus Christ of Latter-day Saints
Do you meet the preauthorization requirements and live in the assigned geographic zone?
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Yes
No
Preauthorization
This form requires a church leaders approval before using and is limited geographically to persons living in Edmonton Alberta east of 50th Street and between 106 - 200 Ave in North Edmonton
Which church leader authorized you to use this form?
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Is your Edmonton AB. home address less than 50th Street and greater than 106 Ave? If not, you need to be seeking help from another church unit.
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Yes
No
Where do these funds come from
Once a month members of the church and the community fast for 1 day and give the money they would have spent on food to the local Bishop as a fast offering to the Lord. 100% of these donations go to finance the Bishops Storehouse and there are no paid employees. We invite all to live the law of the fast to bless the lives of others.
What is a Fast Offering?
Fast offerings are voluntary donations made by members of The Church of Jesus Christ of Latter-day Saints, usually given during Fast Sundays. Members fast for two consecutive meals and donate the money they would have spent—or more if possible—to help those in need. Fast offerings reflect Christ's teachings to care for the poor and needy, allowing members to serve others through their generosity. Fast offerings is a commandment that everyone can live, regardless of where they find themselves.
Do you currently make fast offerings to the church?
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Yes
No
No, but if you show me I will.
How this form will be used
Please outline the specific services or provisions you're requesting. Please answer every question. Submission does not guarantee approval. Your request will be reviewed, and a church leader will notify you of the decision within 48 hours.
Do you provide authorization to the church to use your information to discuss and coordinate with other leaders in the church?
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Yes
No
Do you give authorization that parts of this information is shared with the government?
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Yes
No
Have you sent money to people or organizations outside of Canada in the last 3 months?
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Yes
No
Date
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Month
-
Day
Year
Date
Name
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First Name
Last Name
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
What is your email address?
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Are you a baptized member of the Church of Jesus Christ of Latter-day Saints
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Yes
No
Are you a member of the church?
Have you received help from the church in the last 12 months?
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Yes
No
If applicable, itemize any church assistance have you received in the last 12 months and the total approximate value?
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What is your current situation that requires the help from the church?
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Step 1: Share your Household Income
How many people in the home are working?
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Do those working contribute to your shared expenses?
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Yes
No
Last Month Income
Rows
Monthly Dollars
Work Income
Government Support
Pension Income
Other
Total
If you work, how many hours a week do you work?
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Do you have any disabilities or limitations that limit or prevent you from working?
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Step 2: Share your Household Expenses
Last Month Expenses
Rows
Monthly Dollars
Rent or Mortgage
Transportation
Food
Electricity
Water
Heat
Phone
Internet
Childcare
Child Payment
Misc
Debt
Tithing
Fast Offering
Medical
Education
Other
Total
List all of the people that live in your home, your relationship to them and their age?
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Step 3: Share your Request
What help are you requesting from the church?
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Step 4: Share what actions you have already taken
Before seeking help from the church, please check which resources you have attempted to use first:
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My personal emergency funds
My personal investments and savings
Insurance
Government assistance
Bank loan
Short term lending loan
Selling assets or household items
Cutting costs and unnecessary expenses
Seeking help from friends and or acquintances
Seeking help from family
Seeking an advance from my employer
Providing gig services in the community for cash
What government or community resources are you currently receiving? Seeking community, insurance, and government resources should be your first action as they are designed to help you get on your feet.
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How has your family helped you, and how could they help you? By not engaging with your family you limit the ability to forge better family bonds.
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What steps have taken to either reduce your costs or make more money?
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What steps are you taking to cover your own expenses?
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Why have you selected the church to cover your personal expenses and not the above?
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Step 5: Share additional Information
What has been your attendance in a self reliance financial planning program?
Rows
Yes
No
Have you participated in a church run financial planning program?
Are you willing to participate in a church run financial planning program
What actions are you or your family taking to create an emergency fund so similar needs in the future can be mitigated independently?
What are you willing to do in return for this assistance?
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Submit
Should be Empty: