Urgent Assistance Request Form

My signature below guarantees the information provided above is accurate and true. I also understand that benevolence from this church is a one-time gift and I cannot re-apply for another request for a period of one (1) year. I give Appalachian Church permission to verify any information given on this request for assistance, unless I have noted otherwise, in writing, on this form. Verification of information may include correspondence, phone calls or visits.

Please email us current copies of bills for consideration.

Submitting this form does not guarantee assistance will be granted.
2) The Benevolence Coordinator solely determines granting and amount of assistance.
3) Incomplete forms will not be considered.

4) Dishonesty of any kind on this application will result in denial of assistance.
5) Your signature on this documents grants Appalachian Church permission to verify your
information as it deems necessary.

We MUST have a photo of your current photo ID and a copy of everyone over 18 living in your household to be considered for urgent assistance. If you have any problems with this form, send the photo to our church office at churchoffice@appchurch.org along with your form submission.

Appalachian Church

Worship Playlists:

Urgent Assistance Request Form

We MUST have a photo of your current photo ID and a copy of everyone over 18 living in your household to be considered for urgent assistance. If you have any problems with this form, send the photo to our church office at churchoffice@appchurch.org along with your form submission.