Benevolence Request — Elk Park Christian Church

Applicant Information

Tell us how to reach you and a little about your household.

Full Name *

Please enter your full name.

Address *

Please enter your address.

Phone Number *

Please enter your phone number.

Email (optional)

Please enter a valid email address.

Preferred Contact Method *

Phone Email Text Other

Are you a member or regular attendee of EPCC? *

Member Regular Attendee Visitor / Not affiliated Other

Household Members (name and age) *

Please list household members.

Assistance Requested

Help us understand what you need and your current situation.

Type of Need *

Amount Requested *

Please enter the amount requested.

Vendor Name (who payment goes to)

Vendor Address (optional)

Vendor Phone (optional)

Describe your current situation and specific need *

Please describe your situation.

What steps have you already taken to address this need? *

Please describe steps you've already taken.

Have you requested or received benevolence assistance from EPCC before? *

No Yes

If yes, when and what type? *

Are other local agencies, churches, or organizations currently assisting you? *

No Yes

Which organizations? (optional)

Supporting Documentation

Please attach any relevant documents such as a bill, notice, or estimate. This helps the committee review your request efficiently.

Attach Document (optional)

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Click to browse or drag a file here

PDF, JPG, PNG, or Word document

Acknowledgment

Please read and confirm before submitting.

I affirm that the information provided is true and complete. I understand that submitting this form does not guarantee assistance and that Elk Park Christian Church's Benevolence Committee may approve or deny any request for any reason, based on available funds and ministry discretion. I also understand that if assistance is approved, it will be paid directly to the vendor (not to the individual).

Spiritual Support (optional)

Yes, I'd welcome prayer or pastoral follow-up No, thank you

Something went wrong submitting your request. Please try again or call the church office directly.

Applicant Information

Assistance Requested

Supporting Documentation

Acknowledgment

Request Submitted