Financial Assistance

FAITH COMMUNITY BAPTIST CHURCH
1903 Cool Lane Richmond, VA 23223(804) 649-7225
FINANCIAL ASSISTANCE PROGRAM REQUEST FORM
Faith Community Baptist Church is committed to assisting its members develop every aspect of their lives. We recognize that in addition to meeting the spiritual and educational needs that there are times when members need assistance with their financial needs. The Financial Assistance Program is in place to offer assistance to members who are faced with critical financial distress. However, it should be noted that the determination of assistance is based on three primary criteria.

1. Nature and urgency of need.

2. Availability of resources.

3. History of financial management.

Please be advised that if granted assistance the participants may be required to complete he Credit and Money Management workshop offered here at Faith.
DATE

MonthDayYear
Date
NAME
ADDRESS
PHONE#
Email
example@example.com
Are you a member of Faith Community Baptist Church?

YesNo
NUMBER OF CHILDREN IN HOUSEHOLD NUMBER OF ADULTS IN HOUSEHOLD
NUMBER OF CHILDREN IN HOUSEHOLD
NUMBER OF ADULTS IN HOUSEHOLD
SOURCE OF INCOME
INCOME RANGE
O 10000
10000 20000
20000 ABOVE
OVER
NAME of CREDITOR
Address

ADDRESS

Street Address Line 2

CITY STATE ZIPState / Province

Postal / Zip Code
AMOUNT REQUESTED
DATE NEEDED

MonthDayYear
Date
*Please provide a copy of unpaid billing statement from creditor*

Is this your first request for financial assistance? Have you made a financial commitment to Faith for this year? If yes, how much weekly monthly
File Upload

Cancelof
If yes how much weekly
monthly
other
* Please note that all checks will be made payable to creditor(s) unless otherwise authorized by the Pastor.

FAITH COMMUNITY BAPTIST CHURCH

FINANCIAL ASSISTANCE PROGRAM REQUEST FORM

NUMBER OF CHILDREN IN HOUSEHOLD NUMBER OF ADULTS IN HOUSEHOLD

INCOME RANGE