Kairos Benevolence Fund Application:
Ministry Type
*
I'm a missionary
I'm a minister
I'm a retired missionary
I'm a retired minister
Name of Church or Ministry that Ordained you
*
PERSONAL INFORMATION
Date
*
-
Month
-
Day
Year
Name
*
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Address
*
Street Address
Address Line 2
City
State / Province / Region
Zip / Postal Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Date of Birth
*
-
Month
-
Day
Year
Gender
Male
Female
Marital Status
Single
Engaged
Married
Widowed
Do you have any minor children living with you?
Yes
No
Number of children
Please indicate the ages of any minor children living with you
What is the name of the church you attend?
To the best of your ability, in the space provided below, briefly describe what you believe to be the most important need(s) to be met by the Kairos Benevolence Fund, the situation that created the need(s), the amount of financial assistance needed to meet the need(s), and how quickly the need(s) must be satisfied.
Have you applied to any other private or public organization to assist with meeting this need?
Yes
No
If yes, please name the organization(s)
Have you met with any financial advisors or counselors to address plans for meeting your needs long term?
Yes
No
If yes, please name the organization(s)
Employment Information
Please briefly describe, in the space provided below, the history of your ministry and/or missionary service together with the approximate dates, places, and names of churches and/or organizations:
Are you presently employed?
Yes - Full Time
Yes - Part Time
No
Are you?
Retired
Disabled
Unemployed
Other
If you or your spouse are not Retired or Disabled, and are currently Unemployed, please briefly describe your efforts to find employment and indicate whether you are currently receiving any unemployment benefits or severance benefits from the government or a former employer.
Housing Information
Do you own the home that you are currently living in?
Yes
No
Do you have a mortgage loan?
Yes
No
Amount remaining on your mortgage?
i.e. $50,000
Do you own a home that you are not currently living in?
Yes
No
Please indicate why
If you are not living in a home that you own, please indicate which option best describes your situation
I am living in a parsonage
I am living in a rental property
I am living with a family member or friend
I am living in an assisted living facility
I am in a skilled nursing facility
Other
If you are requesting housing assistance, have you told your Lender, Landlord or other housing provider about your need?
Yes
No
Please indicate how long you have lived at your present location:
i.e. 10 years
References
Please supply the name and contact information for at least 3 individuals that you would be willing for the Kairos Benevolence Fund to contact regarding your need(s). Again, please be assured that all information discussed will remain confidential.
Reference #1
Reference #2
Reference #3
Certification
How did you hear about the ministry of the Kairos Benevolence Fund?
I spoke with a KBF Representative
I saw a KBF video presentation
From CDF Capital
From a friend
From a Center for Church Leadership Representative
Other
By typing your name in the box provided below you are certifying the accuracy of the information you have provided above, that you have carefully read the opening paragraphs, that the Kairos Benevolence Fund has your permission to share the details of this application with its Benevolence Fund Grant Committee, and that the Kairos Benevolence Fund may contact you, and persons you recommend, for more information.
Submit
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