Benevolence

 
At The Gate Church we believe that we have a mandate from God to assist those who are in need, and as such, we adopt a prayerful, nonjudgmental, highly confidential approach to each request with a desire and intent to not just see the need met but also to equip the individual with tools to remedy their situation.
 
Please fill out the form below to the best of your ability and click “submit” when you are done.

    Date

    Name

    Address

    Email

    Gender
    MaleFemale

    Birth Date

    Age

    Marital Status
    SingledEngagedMarriedDivorcedWidowedSeparated

    Spouse Name

    Spouse Address

    Spouse Phone

    Spouse Email

    Please Check Specific Needs Required at This Time

    Please List Specific Amounts and Details Needed for Selected Areas

    List Everyone Who Lives in Your Household
    Name Date of Birth Relationship Income

    Explain How You Came to Be in This Financial Situation

    List Everyone Who Lives in Your Household
    Name -Date of Birth -Relationship -Income

    Present / Most Current Employer

    Employer Phone

    Supervisor

    Supervisor Phone

    Employer Address

    Position and Job Description

    Reason for Leaving (if not currently employed)

    Spouse Present / Most Current Employer

    Employer Phone

    Spouse Supervisor

    Spouse Supervisor Phone

    Spouse Employer Address

    Position and Job Description

    Reason for Leaving (if not currently employed)

    Do You Have a Social Worker?

    Social Worker

    Agency

    Social Worker Phone

    Have You Seen a Financial Planner in the Past 6 Months?

    Who

    Have You Requested Assistance in the Past 6 Months?

    Amount Recieved?

    Friends / Family Contacted

    Church / Agencies Contacted

    What Steps Are You Taking to Improve Your Situation?

    Are You a Member of The Gate?

    Do You Regularly Attend Church?

    What is the Name of the Church You Attend?

    How Long?

    How Frequently?

    Are You a Member?

    Who Suggested You Contact The Gate?

    Relationship

    Have You Previously Received Help from The Gate?

    Phone

    When / What?

    References
    Name - Phone - Relationship