Benevolence Request Form

TELL US ABOUT YOURSELF OR THE RECIPIENT:

First Name

Last Name

Email

Phone Number

Recipient FULL name or organization name (if filling out on the behalf of someone)

Recipient email (if filling out on behalf of someone)

Recipient phone number (if filling out on the behalf of someone)

Recipient Home Address

Recipient Home City

Recipient Home Postal Code

Recipient Marital Status

Recipient Work Status

Part-Time

Full-Time

Unemployed & not looking for work

Unemployed & looking for work

Does recipient actively attend MVMNT Church?

Yes

No

Does recipient attend another church? (if so, what church?)

TELL US ABOUT THE NEED AND WHAT YOU ARE BELIEVING GOD FOR:

In your own words please tell us in detail what you are praying and believing God is going to provide:

Has recipient requested financial help from another church or organization in the last 6 months?

Yes

No

If yes, please explain:

If this is a request for rental assistance please give the NAME & PHONE NUMBER of the landlord/property manager:

Has recipient been financially assisted by MVMNT Church before in any way?

Yes

No

If you answered yes, please explain:

What is the financial amount or total of the request?

Is there a date deadline for the request?

DISCLOSURE: The benevolence fund is intended as a source of last resort, to be used when the family or individual requesting assistance has explored all other possibilities of help from family, friends, savings, or investments. It is intended to be a temporary help during a time of crisis. Do not submit SIN numbers, identification documents, banking account numbers or other sensitive information via this form. Limit of one benevolence application per family per calendar year. Submission of a benevolence application is not a guarantee of funds. Benevolence awards are generally not paid in cash, and are paid directly to service providers (landlord, utility provider, etc.). Any approved benevolence amounts not taken advantage of and awarded within 60 days of approval may be canceled and no longer valid. Please be prompt in providing any requested additional information to aid in payment.

I have read the above disclosure and understand:

I understand

It is very important to MVMNT Church that we are utilizing money that is given by those in the church body in an orderly fashion, with discretion and wisdom. Your cooperation allows us to determine the best way to assist you.

I have read and understand the statement above:

I understand

I acknowledge that the recipient is personally and solely responsible for all taxes, fees, or other costs associated with the donation where applicable.

I or the recipient will not pursue any legal action against MVMNT Church or its employees due to gift losses, damages, etc. I voluntarily assume all legal responsibilities and risks associated with accepting the donation(s). I also understand that this donation is not transferrable to the estate of the recipient and can only be amended in writing as agreed upon by both parties.

Furthermore, I understand that delivery time frames are subject to availability of supplier. By signing this statement, I understand that MVMNT Church bears no liability in regards to the performance and longevity of received gifts and are released of all responsibility upon acceptance by the recipient. I have read and fully understand all information stated above. I also certify that I am 18 years of age or older.

If you have read and understand the above statement please click agree:

I agree

Signature

Please click "SUBMIT" below. One of our team members will be reaching out to you shortly. Please allow up to 2 weeks for processing.

Please note: Our pastoral staff does not make gifting decisions for benevolence requests.
If you have further questions, please email: info@mvmntchurch.com