Benevolence & Care Request Form
Our aim is not just to build a church, but to build people. While we may not always be able to meet every need directly, we are committed to supporting you in meaningful ways. This may include referring you to trusted community resources or services that can provide additional help.
Full Name
First Name
Last Name
Contact Number
Please enter a valid phone number.
Email Address
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Current member?
*
Yes
No
How Long Have You Been Attending?
Nature of Request
Financial Hardship
Hospitalization
Death in Family
Other
Brief Summary of Details of Situation
Requested Support
*
Financial
Meals
Hospital/House Visit
Prayer
Counseling Referral
Funeral/Memorial Service Assistance
If you are requesting financial support, please indicate your current employment status and source of income.
Please list prior hardship requests within the last 6 months
Total amount requested ($):
Max 1,000
Urgent request? *Eviction notices, utility shut off warning, or immediate health or safety concerns
Yes
No
*
I, hereby, declare that the information above is true and complete.
*
I acknowledge that Reach City Church will prayerfully consider my request but is not obligated to fulfill it. I give permission for Reach City Church to verify any information necessary to process my request
*
I understand my request will be reviewed within 3–5 business days and that financial assistance is prioritized for active Reach City members.
Upload any relevant documentation, such as bill, notice, etc.
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