Financial Assistance Form
The Leadership Team (LT) is charged with the Biblical stewardship and oversight of money donated to the Crossbridge Christian Church Compassion Fund. Therefore, a reasonable degree of verification of the self-reported financial situation of applicants is necessary. To that end the LT asks that each applicant provide statements showing current financial data, and be willing to provide similar documentation at any time the LT requests it while he or she is receiving assistance.

*By submitting this form you are providing true and accurate information and understand that misrepresentation or falsification of information could disqualify you from receiving these funds. Please scan and email a copy of your bill due to leadershipteam@crossbridgechristian.com. If you have questions about your submission, please send us an email or leave a message with our church by calling (850) 583-0712.

Name
First and last name
Your answer
Email
Your answer
Phone number
Your answer
Street Address
Your answer
City
Your answer
How were you referred to the Leadership Team?
Your answer
Do you attend Crossbridge?
Type of Assistance Requested:
Required
Explain "Other":
Your answer
What is the value of your total current assets, not including any living necessities such as a house, vehicle, medical equipment or household furnishings?
Your answer
What is the value of your current outstanding debts?
Your answer
What circumstances created your need:
Your answer
Dollar amount requested:
Your answer
Payable To:
Your answer
Have you met with ECHO?
Please Explain any other financial assistance you have received from other organizations or agencies?
Your answer
Additional prayer requests or support needs:
Your answer
Check here to indicate that Crossbridge has your permission to contact other community organizations regarding your request
Required
I have read and understand the Crossbridge Christian Church Benevolence Fund Policy and Guidelines and I understand that funds from the Crossbridge Christian Church Benevolence Fund are disbursed at the discretion of the LT, in accordance with the Policy and the Biblical principles listed therein, and are dependent upon money being available in the Fund. I also understand that the LT may re-evaluate my situation at any time.
Required
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