Financial Assistance | Free People Church

Application Purpose
Free People Church seeks to be a source of support to those in our community that are in need, particularly those who are actively engaged in the Free People Family. These guidelines are not meant to discourage you, but to allow us to be better equipped to evaluate your current situation and determine how to best help.
Application Process and Limitations*
Limitations of Usage: You may apply for financial assistance from Free People Church not more than once every six months. If you have not regularly engaged in serving, giving or Growth Groups at Free People for at least six months, your assistance limit is one $50 Kroger gift card.

Interview: Applicants may be interviewed before a final decision is made. We reserve the right to ask for documentation to verify eligibility for assistance. In-person interviews can only be scheduled following the last service on a given Sunday.

Processing: This application is to be completed prior to the interview process. Please allow one week for review of your application. You may be contacted via phone, e-mail or letter.

Payments: Payments will be made to third parties only.

Documentation: All applicants are required to complete the Financial Assistance Application in its entirety. Applicants are also required to provide supporting documents where needed (i.e., valid ID, invoices, bills, etc.).

Availability of Funds: Free People Church may provide assistance with the following: rent, utilities, food, clothing or other emergency needs, depending on available funds and the nature of the need requested.

Exclusions: Free People Church will not pay for non-emergency items, which include, but are not limited to cell phone bills, cable/satellite TV bills, insurance payments, credit card bills, etc.
I have reviewed and understand the limitations and process.

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Requirements
Anyone who engages in serving, giving or Groups at Free People is eligible to apply for financial assistance as needed. Any other community member within 20 miles of the church location is eligible to complete the application process with the restrictions outlined below.
Have you applied for financial assistance at Free People within the last six months?*
Households are only eligible once every six months.
Do you currently attend Free People Church?*
Do you live within 20 miles of Free People Church?*
Our address is 453 W Main St, Mt Orab, OH 45154. Community applicants must live within 20 miles of Free People Church.
Consent to Restrictions
I understand that because I am not a part of the Free People Family, my ability to receive financial assistance is limited to $50 and there is no guarantee of financial support from Free People Church.
I agree to the restrictions

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How long have you attended Free People?*
Have you been in a Small Group?*
What was the last Group you were a part of?*
Are you currently serving?*
What team do you currently serve on?*
Do you consistently tithe?*

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Name*
First Last
Phone*
Email*
Enter Email Confirm Email
Address*
Street Address City State ZIP Code
Birthdate*
MM slash DD slash YYYY
Gender*
- Male
- Female
Marital Status*
Spouse's Name*
First Last
Spouse's Birthdate*
MM slash DD slash YYYY
Please enter all people currently living in your home
Click the + icon to add additional rows
Name Relationship Age

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Are you currently employed?
- Yes
- No
Your Employment Info
Your Employer
Your Employer's Address
Street Address City State ZIP Code
Your Employer's Phone
Your Monthly Take Home Pay
Other Income (alimony, child support, etc.)
Is your spouse currently employed?
- Yes
- No
Your Spouse's Employment Info
Your Spouse's Employer
Your Spouse's Employer's Address
Street Address City State ZIP Code
Your Spouse's Employer's Phone
Your Spouse's Take Home Pay
Your Spouse's Other Income (alimony, child support, etc.)
Household Expenses
What are your total monthly household expenses (budget)?*
Do you currently have a household budget?*
- Yes
- No
What are your plans for implementing a household budget?*
Do you have adequate income to support your budget going forward?*
- Yes
- No

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Your Requested Need
Please complete the following to provide information on the need for which you are requesting financial assistance. Provide as much detail as possible.
Please describe your current need.*
How much financial assistance are you requesting?*
Please explain in detail the circumstances which brought about this need.*
What steps have you taken to address this need?*
Have you been helped previously by this or any other church?*
- Yes
- No
Who helped you, when did they help you, and how did they help you?*
What other organizations or personal contacts have you reached out to for assistance on the current need?*
How are they able to assist you?*
Because you (or your spouse) are unemployed, what adjustments have you or will you make to avoid this happening next week/month?*

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Is this for an upcoming or overdue bill?*
We only provide assistance payable directly to third parties.
- Yes
- No
Bill Information
Company Name*
Contact Person
If applicable
Company Phone*
Company Address*
Street Address City State ZIP Code
What is your account number?
If applicable
Please upload a copy of the bill
You can attach a file here or take a picture of the bill with your phone
Drop files here or

Max. file size: 10 MB, Max. files: 5.

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Personal References
Please enter two non-family references below.
Reference 1: Name*
First Last
Reference 1: Phone*
Reference 1: Address*
Street Address City State ZIP Code
Reference 2: Name*
First Last
Reference 2: Phone*
Reference 2: Address*
Street Address City State ZIP Code

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Personal Identification
Please upload a copy of your driver's license.*
If on your phone, you will be able to take a picture directly with your phone.
Drop files here or

Max. file size: 5 MB, Max. files: 2.
Driver's License Number*
Driver's License State*

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Certification*
By electronically signing this application, I am certifying that all information entered is complete, accurate and truthful. I have not applied for financial assistance from Free People within the last six months. I understand that financial assistance will only be made payable to third parties. I understand that consideration for assistance is only applicable to emergency needs, such as rent, utilities, food, and clothing, and Free People will not consider helping with non-emergency items, such as bills for TV, cell phones, insurance payments, credit cards, etc. I understand that there is a waiting period for consideration before a decision will be made.
I agree that all information provided is accurate and truthful, and I agree to the statement above.
Electronic Signature*
By entering your name in this box, you are electronically signing this application and certifying that all information provided is true, complete and accurate.
Signature
Comments
This field is for validation purposes and should be left unchanged.

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Name	Relationship	Age

Financial Assistance Application

Step 1 of 10

Application Purpose

Requirements

Your Employment Info

Your Spouse's Employment Info

Household Expenses

Your Requested Need

Bill Information

Personal References

Personal Identification