Form Benevolence Application We understand that needs arise from time to time in which assistance could be helpful. We have Benevolence Deacons available to meet with you to determine if your need is one we might assist with. Please use this form ahead of your meeting to allow our deacons to be familiar with your particular need. Name* First Last Address Street Address City State / Province / Region ZIP / Postal Code Phone*Email Driver's License NumberDrivers License StateYear, Make, and Model of AutomobileAutomobile Color, License Plate, and State of LicenseAutomobile Insurance Company and Policy NumberWhat is your need? Please be specific.*How many people are involved in this need (show adults/children)?*Where do your closest relatives live?*Is your family aware of your need?*Are you receiving financial assistance from the government or any other agency (unemployment, social security, workers comp, student loans)? If so, which one(s)?*Have you sought assistance at any other churches or non-profit groups in this area? If so, which one(s)?*Do you attend church? If so, where?Are you employed? If so, where? If no, when were you last employed?*If you are traveling, what is your destination?If you are not traveling, how long have you been in this area?Who referred you to us?*If we are unable to help you, what other options do you have?*Request AppointmentI would like to meet with a Benevolence Deacon on the next Tuesday or Thursday at the time indicated below.Tuesday at 9:00amTuesday at 9:30amTuesday at 10:00amProof of need must be established, please upload documents that support, and help us understand your need. Examples: copy of your utility bill, rental or mortgage bill etc. Please also provide a copy of your photo I.D. Drop files here or I understand that FBC Warrensburg is not a government assisted agency. All available resources are a result of direct donations from FBC congregational partners.* Yes No CAPTCHA Δ
