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.
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.
You MUST email a photo of your current photo ID and a copy of everyone over 18 living in your household to appalachianchurch@gmail.com to be considered for urgent assistance.
Thank you for applying, we will get back to your shortly!
