The Agape Fund

The Agape Fund is a fund that is set aside through gifts of the congregation to assist members and LOCAL non-members alike with short-term, ONE-TIME, financial assistance. The fund is administered on a confidential basis. We do not provide any monies directly to individuals, but rather provide resources to help with bills, repairs, food, etc.

Please fill out this form completely.

Name

First Name

Last Name

Subject

Phone Number

(###)

###

####

Mailing Address

(PO Box, if applicable)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Family Information: Spouse's Name, Children(s) Names

Employer: Name and Phone Number

Monthly Household Income

1. Statement of Need: Please write a brief statement of the circumstances that have created the basis for your request. Please indicate whether your situation has been developed over a considerable period of time or whether this is a sudden and unexpected emergency.

2. Financial Liability: Please indicate the nature and exact dollar amount of your outstanding bills or financial difficulty.

3. Statement of Request: Please indicate the specific dollar amount which you are requesting, which will satisfy your financial needs.

4. Alternatives: If the Agape Ministry is unable to provide financial assistance, what other means of help would bring some relief to your situation?

5. Other sources of help? Are you currently receiving assistance from any other sources, public or private? Are you seeking help from any other sources? Have your requests for help been rejected by any other sources?

6. Counseling: Are you willing to receive spiritual, financial or other types of counseling if required by the Agape Team?

Yes - Please be willing to explore a free financial consultation at: https://financialgym.com/promo

7. References: Please list any family members, friends or acquaintances (contact information) that the Agape Team can talk to concerning your circumstances.

8. Has the Agape Fund helped you with assistance before as a ONE-TIME grant? When? ***Please note that if we helped you before, we are UNABLE to extend help again at this time (we will verify).

9. How did you hear about the Agape Fund?

10. Do you speak English or have a translator available to discuss your case? Please list their name and phone number below.

We provide assistance to LOCALS in Blaine County only. I understand that my request is for a ONE-TIME grant and that by giving a grant, the Church of the Big Wood is not obligating itself to any future financial responsibility for me or my personal financial obligations.

Signature

*** Please note the application process takes 7-10 business days, and is not a quick means for financial assistance.