Benevolence Application

At Bethel Baptist Church we strive to support active members facing financial hardships due to unforeseen circumstances. Our goal is to provide temporary assistance for essential needs such as food, shelter, and clothing, while also encouraging long-term financial health through practical teaching and counseling. If you are an active member with an emergency financial need, please complete the Benevolence Application below. Applications must be fully completed and may be submitted once per calendar year, with a maximum of two requests per person. For non-members, while we cannot guarantee assistance, we will assess your situation and inform you of any available support. After submitting your application, our Benevolence Team will review it and follow up with you. Your request will be prayerfully considered by the Benevolence Ministry to determine how we can best assist you.

 

Name(Required)
Spouse's Name
Email(Required)
Spouse's Email / Other Adults Email
MM slash DD slash YYYY
MM slash DD slash YYYY
Applicant:(Required)
Please Provide, Name, Age, Relationship, Student/Employed
Name of church you attend:
Status at Local Church(Required)

1st Personal Need

When is this bill or need due by?
MM slash DD slash YYYY
The name of utility company, or bill that is due.
Entity Address
Address of the utility company, or bill that is due.
Account Number Needed To Pay Bill

2nd Personal Need

When is this bill or need due by?
MM slash DD slash YYYY
The name of utility company, or bill that is due.
Entity Address
Address of the utility company, or bill that is due.

Status of Need

Have you received:

Referral

Who referred you to Bethel
Have you asked the church you attend or other charitable organizations or agencies?
MM slash DD slash YYYY

Please list at least three places where you have applied for work:

MM slash DD slash YYYY
MM slash DD slash YYYY
MM slash DD slash YYYY
Name
Please list two references who we may contact:
Address
Name
Address

FINANCIAL STATEMENT – CONFIDENTIAL

List Out All Monthly Income
$
$
$
$
$

ASSETS

MONTHLY EXPENSE AND DEBT

Monthly Expense - Amount Due - Total Loan
Home
Either your House Payment or your Rental Payment
Monthly Expense
Amount Due
Total Loan
 
Gas
Monthly Expense
Amount Due
Total Loan
 
Electricity
Monthly Expense
Amount Due
Total Loan
 
Water/ Sewer
Monthly Expense
Amount Due
Total Loan
 
Internet / TV Subscriptions
Please combine and total them.
Monthly Expense
Amount Due
Total Loan
 
Vehicle and Gas Maintenance
Monthly Expense
Amount Due
Total Loan
 
Groceries / Household expenses
Monthly Expense
Amount Due
Total Loan
 
Childcare
Monthly Expense
Amount Due
Total Loan
 
Unpaid Taxes / Other Loans / Monthly Obligations
Monthly Expense
Amount Due
Total Loan
 
1. In connection with my request for benevolence, this application may include, but is not limited to, information about my general character, payment history and references. I hereby authorize the designated agent(s) chosen by Bethel Baptist Church to verify any of the records and information in this application and any other documents provided.
2. I acknowledge that submitting this online application shall be as valid as a paper copy.
3. I hereby release the employer and agents and all persons, agencies, and entities providing information or reports about me, from any and all liability arising out of requests for or release of any of the above mentioned information or reports. This information is confidential and will not be used for any other purposes.
4. I have accurately represented all of my income, assets, and debts as described in the Financial Statement section of this application. I lack the resources to meet the need described in this application.
5. I acknowledge that Bethel Baptist Church is obligated to report any suspected child and/or elder abuse and/or neglect to the appropriate governmental or social services agency.
6. I acknowledge that I need to fill out the application completely; an INCOMPLETE application may not be processed.