About
Meet Our Pastors
Visit
Ministries
Outreach & Mission
Women's
Events
Watch
Sermons
YouTube Channel
Give
Connect
Church Center
Connection Card
Resources
Benevolence Request
Name
Date
Address
Email
Phone (Home)
Phone (Work)
Are you a member of Real Church?
Yes
No
If no, Are you a member of any church?
Which best describes your attendance at Church?
Frequent
Sometimes
Seldom
Never
In your opinion, which description best describes your financial situation?
Short-term emergency
Short-term problem
Long-term problem
Have you requested assistance from REAL Church in the past?
If so, when:
If assistance was given, how much:
Are you currently employed?
Yes
No
Full Time (FT)
Part Time (PT)
Name of Employer:
How long have you been employed by this company?
If married, is your spouse currently employed?
Yes
No
Full Time (FT)
Part Time (PT)
Name of Employer:
Total number of people in your Household:
Weekly:
Monthly:
Household Monthly Expenses: (Total) $
Rent/Mortgage
Utilities
Food
Medical
Car (Insurance/Payments)
Internet/Cable
Loans
What is the purpose of the request?
What is the total amount of your request?
Briefly, explain your needs and what led you to request assistance:
Are you willing to participate in financial counseling?
Yes
No
Submit
