Monday Example_FA Request & Budget

  • Financial Assistance Request Form

    Our vision is to partner with the community to transform lives... we look forward to hearing your story.

  • *Please note that we are currently only able to assist clients in the cities of Bulverde, Spring Branch, Canyon Lake, Fisher, and Blanco. You can visit our website www.hopecenterministries.com for a list of additional resources.

  • Please fill out the form below. This form must be completed by the person whose name is on the bill for which you are requesting assistance.

    For example: If you need assistance repairing your car, the person on the car loan/title must be the person filling out the form
  • Format: (000) 000-0000.

  • We currently are only able to assist clients in Spring Branch, Bulverde, Canyon Lake, Fisher, and Blanco.

    We apologize that we are not able to personally assist you at this time but encourage you to check out SACRD.ORG to find a list of resources for any needs you may have based on your area.
  • Date of Birth*
     - -
  • Driver's License Expiration Date
     - -
  • Are you employed*
  • Active Duty Military*
  • Veteran*
  • Do you receive Food Stamps (or TANF)*
  • Are you legally married?*
  • Spouse's Date of Birth
     - -
  • Are there persons besides you & your spouse living in your household*

  • Please list ALL persons living in your household

  • Male or Female
  • Is there anyone else living in your household
  • Male or Female
  • Is there anyone else living in your household
  • Male or Female
  • Is there anyone else living in your household
  • Male or Female
  • Is there anyone else living in your household
  • Male or Female
  • Is there anyone else living in your household
  • Male or Female

  • List TWO personal references NOT living with you

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Are you a member of (or do you regularly attend) a church*
  • Have you sought assistance through any other channels or resources?*

  • Name of Agency Assistance Requested    Pick a Date   

  • Name of Agency Assistance Requested    Pick a Date   

  • Name of Agency Assistance Requested    Pick a Date   

  • Name of Agency Assistance Requested    Pick a Date   

  • Have you ever received FINANCIAL assistance from The Hope Center in the past? Please note that it is our general policy to offer financial assistance not to exceed $250 annually per household.*

  • Monthly Budget

    Please use your "bank statement" to fill out the budget below to the best of your ability. This will not only help us to serve you better now, but it will also allow us to better assist you in achieving financial independence and stability. You will need to bring your statement with you when you meet with us. Your statement may be from a traditional bank or any other platform you use to send/receive money (PayPal, Venmo, Cash App, etc). Your budget should reflect each entry for the entire month.
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  • By clicking "SUBMIT," I acknowledge and hereby certify that all the information provided on this application and information shared verbally is correct and true. I also acknowledge that any information given that is found to be false may disqualify me from consideration. By clicking "SUBMIT," I hereby authorize The Hope Center to release, either verbally or in writing, any and all information, records, or documents pertaining to me to any individuals, organizations, or entities involved in providing community benevolence. Any person releasing said records is authorized to discuss those reports with recipients of financial assistance funds and fellow non-profit organizations; additionally I give permission for The Hope Center to verify my employment and contact my references. Furthermore, The Hope Center is expressly authorized to obtain my records currently on file with any living program or charitable organization and to retain such information in its database. Any information obtained may be used to grant or deny any request made to The Hope Center for assistance. A copy of this authorization has the same force and effect as an original. Once submitted, this application and the copies of any all required paperwork becomes the expressed sole property of The Hope Center and will not be returned to the client.*
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