Mechanics Ministry Benevolence Application
Application for reduced labor rate
Date of Application
Mechanics ministry benevolence rates are valid for 6 months from the date on the application.
Applicants Name and Contact Information
City State Zip
Who is your current employer?
How long have you been working there?
Spouse or other Adult
List the name of your spouse or other adult in the household
Spouse or other Adult Employer
Who is their employer?
How long have they been working there?
Include state car is licensed in.
Method of payment
We are sorry but we are unable to make payment arrangements
Depending on the number of people in your immediate family and your household income, you may be eligible for a reduced hourly rate discount for service on your vehicle. Some services are not eligible for the discount and have a flat fee.
Number of family members living in your house including yourself
Names of Household Member
Include their name, age, and their relationship to you
Gross Monthly Income
Include the total income of all of the household members. This includes child support, disability income, and social security. Verification of income is required in order to process your application.
I hereby give my consent to Cedar Park Assembly of God Church to share the information contained in my application form including other material I have provided to support my application for aid with Cedar Park Pastors, volunteers and staff members, churches or agencies as Cedar Park Church , in the exercise of its reasonable discretion, might see fit. I also give Cedar Park Church express consent to verify any information contained on this form, including attachments or supplements I have provided, in order to determine the extent, legitimacy and duration of my need.
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This form was created inside of Cedarpark Church and Schools.
Terms of Service