Harvest Point Fellowship Church Financial Assistance Form
Harvest Point Fellowship church has established a fund for the purpose of providing short-term financial assistance to its members. Assistance from the church will take into account the use of one’s personal resources, including family assistance (such as parents, children, relatives, etc.). Please review and complete the entire form. While we certainly want to assist you in your time of need, even if approved we may not be able to provide full amount of request. Any approved funds will be made payable to the provider of the service and usually not to the member directly.
Email address *
Not all situations qualify for this assistanc8e. Wise stewardship dictates that assistance be extended when unexpected and serious circumstances develop, creating a hardship in which the health, safety or welfare of one or more members of the household is directly affected. Typically, these hardships are the result of a job loss, an accident, illness or death in the immediate family.

Examples of eligible expenses may include by are not limited to:
Funeral expenses
Monthly bills – Rent/Mortgage, Utilities, etc.
Medical bills not covered by insurance for necessary, non-elective medical treatment
Relocation to another residence because of fire, flood, or domestic violence

Examples of expenses that are typically NOT eligible include, but are not limited to:

Attorney fees Reimbursement for unpaid sick time
Tuition expenses Income/Property taxes
Bail Money Credit card debt
Car payments/insurance/repairs Bill consolidation loans
Repayment of loans to family/friends
Home repairs or relocation to another residence (unless it is a result of a fire, flood, domestic violence or
other catastrophic event)
Our desire is to help you. In order to assure that we are serving you in the best manner and be good stewards of God’s resources, we need to understand you and your financial circumstances. Your information will only be disclosed to
those involved with your situation.
1. Complete all information on the application and sign it (type your name). If additional documents are requested, those documents should be emailed to assistance@harvestpoint.org.

2. Please know that your request will normally take 5 to 7 business days to evaluate and process.
First and Last Name *
Phone number *
Full Address *
# Street, City, State, zip code
Email *
If married, spouse name.
How long have you been a member of Harvest Point? *
Current employer and length of employment? *
Please include the start date of employment.
Previous employer and length of employment there? *
What caused your financial shortcoming? *
How much are your requesting and what is it for? *
What steps have you taken to resolve the issue? *
List individuals you have contacted and asked for financial assistance. Please also advise us of the nature of your relationship to the person and their response to your request.
If you were approved for an amount, what is the complete name and address of the Payee? *
Never submit passwords through Google Forms.
This form was created inside of Harvest Point Fellowship. Report Abuse