Financial Assistance Form
Please read the following*
Note: Before completing the form, please review the qualification guidelines. If you do not qualify, no financial assistance (Utilities/Mortgage/Rent) will be granted at this time. A list of other entities that can assist you will be provided upon request.
Qualification Guidelines:
1. Partnership tenure of at least six (6) months from completion of Commit Class.
2. Funds availability
3. No cash given to applicants
4. Check(s) made out to vendor
5. Partner must have a consistent record of giving of tithe and offering for the past six (6) months on The Revive Church records
6. No assistance granted in the past 12 months, year to date
7. Assistance is given per family
8. Applicants may only apply for one category per year.
FOOD REQUEST - Revive does not have a food pantry. We do have partners with food pantry's that we can refer you to.
UTILITIES REQUEST - When a partner in the body desires assistance with their utilities, the following dollar amounts and conditions shall be considered toward such, and the dollar amount shall not exceed these listed below:
Power (Light) bill not to exceed $250.00
Gas bill not to exceed $250.00
Water bill not to exceed $150.00
MORTGAGE, RENT OR LEASE PAYMENT REQUEST-Assistance towards mortgage or rent may be granted up to $500 total. If this assistance will not bring your account to current, it will not be given. Assistance amount should be determined according to the need and available cash. If request is granted, the check/payment will be made payable to mortgage company, landlord, or lessor. The mortgage, rent, or lease should be in the name of the requestor.
NO ASSISTANCE OR PAYMENT MADE TOWARDS THE FOLLOWING:
Telephone bills
Car notes
Personal or consumer loans
NSF (Non-Sufficient Funds) checks
Funeral expenses
Out-of-town travel expenses
School tuition, daycare
Insurance of any kind
Weddings
Bail
COMPLETING THIS FORM DOES NOT GUARANTEE APPROVAL.
Have you read and understand the qualifications for requesting assistance?
If you do not meet the requirements for assistance, please click the resources below for additional local resources which may be able to help.