Mercy Ministry Fund Request Form
"So then, as we have opportunity, let us do good to everyone, and especially to those who are of the household of faith.
- Galations 6:10
Company/Organization (if applicable):
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Date of Request *
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Name *
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Address: *
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Email: *
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Phone: *
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Preferred method(s) of communication *
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Questionnaire *
Complete the following questions so that we can better understand your circumstance and the purpose of your request. After submitting this form, your request will be evaluated by the Deacon's Fund Committee and you will be notified via email or phone as to whether your request has been granted. Briefly explain your needs and what led you to request assistance. If you are making a request, on behalf of another person or party, briefly explain who would benefit from this grant:
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Total amount of request: *
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Is this a short term or long term situation? *
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Are you a member of Gracepoint Church? *
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Are you a regular attendee of Gracepoint Church? *
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Are you willing to receive financial counseling? *
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Are you married? *
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Total number in the household: *
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Are you currently employed? *
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If so, please provide the name of your employer:
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Signature: *
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Date: *
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