MASTER-In Christ's Way

Financial Assistance Application
Please direct all questions about In Christ's Way to assistance@inchristsway.org. Contacting the email above directly is the best way to receive accurate information.
IMPORTANT

Please read carefully before continuing
- Answer every question completely
- Upload all required documentation
- Incomplete applications and/or missing documentation will not be reviewed
- Any application containing false information will be rejected
- Submitting this form does not guarantee assistance

Employment and Household Income
Total Weekly Work Hours*

Full Time (35 Hours/Week or more)Part Time (34 Hours/Week or less)SSI/SSDI is my household’s sole source of incomeUnemployed
Check All That Apply*
Proof of Income-Pay Stubs/Benefits Letter

Attach a copy of the last TWO pay stubs you received here or SSI/SSDI Benefits Letter
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Place of Employment*
Enter the name of the company you work for
Applicant's take home pay each MONTH*
Please enter the monthly total only!
Job Title and Duties Performed*
Enter job title and briefly describe your job duties
Start Date for Current Job/SSI Benefits*

MonthDayYear
Do you receive any other type of income (Child Support, Food Stamps, TANF, Alimony, SSDI, SSI, VA Benefits)?*

YesNo
Check all of the following types of income that you receive*
Food Stamps Monthly Amount*
Enter total amount of food stamps received each month.
Attach Food Stamps Benefits Letter

Please attach a picture of your benefits letter here
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SSI Monthly Amount*
Enter total amount of SSI received each month
SSI Beneficiary Name and Relationship to Applicant*
Enter the name and relationship of the person who receives SSI
SSDI Monthly Amount*
Enter total amount of SSDI received each month
SSDI Beneficiary Name and Relationship to Applicant*
Enter the name and relationship of the person who receives SSDI
TANF Monthly Amount*
Enter total amount of TANF received each month
Child Support Monthly Amount*
Enter total amount of child support received each month
Retirement Benefits Monthly Amount*
Enter total amount of Retirement Benefits received each month
VA Benefits Monthly Amount*
Enter total amount of VA Benefits received each month
Other Monthly Amount*
Enter total amount of any other income not listed above
Other Income Source*
Please specify who or what provides this income. Make sure this is a separate source from any income listed above

Type of Need and Crisis
Have you ever been assisted financially by Frazer In Christ's Way before?*

YesNo
When and how were you assisted?*
Please describe in detail the emergency or events beyond your control that caused you to fall behind on your bill(s):*
To help us accurately assess your request, please include timelines, relevant details, and upload any documentation below that helps us understand and verify your situation
Attach documentation of your emergency here. Upload any documentation that helps us understand and verify your situation.

NOTE: Do not upload the bills you are requesting to be paid here. You should upload things such as medical bills, auto repair invoices, police reports, etc.If you have more than 5 documents that need to be uploaded, please email remaining documents to assistance@inchristsway.org
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What is your plan going forward to cover your expenses:*
Do you have a church home?*

YesNoLooking for a new church home
Name of the church you attend*
Have you asked your church for financial help?*

YesNo
Briefly explain how they have helped*
How did you hear about Frazer's In Christ's Way financial assistance program?*

Household & Previous Employment
Marital Status*

Never MarriedMarriedDivorcedSeparatedWidowed
If married, divorced, widowed or separated, since what date?*

MonthDayYear
Number of OTHER adults in the home (18 and older)*
EXCLUDING YOURSELF, how many people 18 years or older live in your home? List EACH adult below-click Add New to add more adults.
TOTAL children live in the home (17 and under)*
Include all children currently living in the home. To add more children, click Add Row.
Other Adult's Information*
Children*
Other Adult's Previous Employment*
Your Previous Employment*

Budget Sheet

Please fill out the household monthly expenses in the blanks below. You can estimate if needed. If it is not a monthly expense for you then please input 0 in the blank provided.
Total Monthly Income*
IMPORTANT! Please enter the sum of ALL sources of income here. Job, benefits, government assistance, etc for the entire household
Mortgage*
Rent*
Power*
Gas*
Water*
Mobile Phone*
Enter Monthly Bill Amount-NOT cell number
Internet*
Cable*
Car Payment*
Car Insurance*
Child Care*
All Other Loan Payments*
Groceries*
Total Expenses
If the amount requested on your application is approved by the Board, will you be caught up on all bills?*

YesNo
Signature*

Clear
Should be Empty:

Financial Assistance Application

IMPORTANT

Basic Information

Employment and Household Income

Type of Need and Crisis

Household & Previous Employment

Budget Sheet