Benevolence — The Quest Church

the quest church

Benevolence Application

Note: Information given on this form is confidential and will not be disseminated to anyone other than the Board and others directly necessary for accounts payable and church accounting processing.

Name

First Name

Last Name

Spouse name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Company/Name on invoice

Collection Agency Information

Account/Invoice #

Collection Agency Information

Amount requested

Date of request

YYYY

Purpose

Please explain why there is this specific need.

Are you a Partner with The Quest Church?

Are you affiliated with The Quest Church?

Are you related to an employee or Board member of The Quest Church?

If Yes: Who, and what is the relationship?

Have you received assistance from The Quest Church within the last 12 consecutive months? If yes, explain:

Have you received financial counseling / attended Financial Peace University? If yes, include date attended / certificate.

Requestor's name if different from applicant

First Name

Last Name

Please add any additional information that may help the Board to make a better-informed decision. In addition, record confirmation number/check number/credit card information as means of payment.