Benevolence Form - The Journey North Community Church

Benevolence

Benevolence Request

(This is a confidential application for review by the Benevolence Committee Only) Our Benevolence program is designed to help our church family. In order to be considered, this application must be filled out completely. Note: Any money given is intended to be a one-time gift to help bridge the financial gap at a time of extraordinary need.

Step 1 of 5

Applicant Information

Name *

First

Last

Date of Birth *//

Email *

Phone - Primary *

Phone - Work/Day

Address *

Address Line 1

Address Line 2

City

State

Zip Code

How long have you lived at this address? *

Days/Months/Years

If less then 3 years, please list your previous address(s)

Address

Marital Status *

What is your involvement at TJN? *

Have you served as a volunteer at TJN? *

Are you in a small group? *

Are you currently employed? *

Employer Name - Please list as much information as possible. This will help us in making our decision in regards to your benevolence request.

If unemployed please list most recent employment

Employer Phone Number

Occupation

Employment Dates

From/To

Benevolence

Applicant Information

Spouses Information If applicable

Please list other members living in the household

Monthly Income Information

Monthly Expense Information

Utilities

Transportation

Personal

Credit Cards

Tell us about your your need and how you feel we can best help you.

Benevolence

Applicant Information

Spouses Information *If applicable*

Please list other members living in the household

Monthly Income Information

Monthly Expense Information

Utilities

Transportation

Personal

Credit Cards

Tell us about your your need and how you feel we can best help you.

Spouses Information If applicable