Helping Hands Assistance Application

Please Read

This benevolence form is not a contract for assistance, nor is it a guarantee of assistance. We will do the best we can with the resources we have on a case-by-case basis. *You may be asked to signed a hard copy of the application and/or asked questions regarding the answers given.

Personal Information

Church Information




Current Employment




Previous Employment

Previous Employment #1


Previous Employment #2


Income Information

Add monthly income amounts in the following fields below.

Request Needed



Notice to Requestor

Following submitting this form you will need to email Monthly Expense Documents, Invoices / Bills regarding this request, and your Bank statement to our Helping Hands Team


This benevolence form is not a contact for assistance, nor is it a guarantee of assistance. Your Signature indicates you understand and agree with the following:

1. Helping Hands Ministry will refer you to outside/appropriate agencies (e.g., Unemployment Office, Welfare Dept., etc.)

2. Helping Hands Ministry reserves the right to follow up on any information provided to the Committee. The Helping Hands Committee will be sensitive to confidential information.

3. Helping Hands Ministry hold you accountable for taking steps to remedy this situation

4. Assistance is intended to be a gift. Under no circumstances is a gift from Helping Hands to be considered a loan. No gift may be repaid in part or in full, in money, or in labor.