ACTS Ministry Acts of Caring Through Service
ACTS Ministry Acts of Caring Through Service APPLICATION FOR ASSISTANCE
Steps for Assistance: 1. Application You can get an application by: • Printing one from www.hope.church • Calling the Church Office 541.926.2291 and having one mailed to you • Picking one up at the Church Office Monday-Thursday 8-4:30 or Friday 8-12 • Choosing one from the Sanctuary foyer literature racks 2. Fill out ACTS Application for Assistance 3. Call the Church Office 541.926.HOPE (4673) ask for ACTS Ministry 4. Meet with ACTS committee member to turn in application and qualify 5. Assistance days are Monday and Thursday, 9-11:30 am What if I need help right away? We may be able to give immediate assistance if you qualify What do I need to bring to the interview? You will need to bring: • •
Rent or mortgage payments, billings, utility notices Other documented proof of need
What can I expect in the application process? Appointment process: • • • •
Review applicant’s application Determine and verify need if possible Prayer Offer assistance
After assistance has been given, there will be a follow-up call or visit.
APPLICANT’S INFORMATION AND ASSISTANCE NEEDS ARE KEPT CONFIDENTIAL
ACTS Ministry Acts of Caring Through Serving
Date: __________________________ Financial aid, as well as food and other services, are given generously to those who are a part of our church family Those not a part of our church family are first referred to other appropriate community agencies before we evaluate any needs that we may be able to meet. Applicant’s Name: ________________________________________ Phone: ___________________________ Street Address: ___________________________________________ City: ____________________________ Family Information List members living in your household and specify relationship: ____________________________________
_________________________________________
____________________________________
_________________________________________
Financial Status Present source(s) of income: __________________________________________________________________ _________________________________________________________________________________________ Current Needs I need help with: ___________________________________________________________________________ _________________________________________________________________________________________ Cause of your present need: __________________________________________________________________ Have you received other services within the last 30 days (health care, delivered meals, etc.)? Y N If so, who from? ___________________________________________________________________________ Do you have an eviction or foreclosure notice? Do you expect to get a utility shut-off notice?
Yes Yes
No No
Does anyone in your household have health insurance now?
Yes
No
How did you find out about ACTS Ministries? ____________________________________________________ If referred by someone else, please give the name of the person or organization: _________________________ __________________________________________________________________________________________
My involvement at Hope Church Involvement is more than just Christmas and Easter attendance. It is a week-by-week commitment to Jesus that says, “I believe in the God-given ministry of this church and support it with my time, talent, prayers and resources.” I am involved in the life of the church in the following areas: Church attendance (check only the areas of regular attendance): None
Sunday AM
Sunday PM
Wednesday
Other areas I am involved in (for example Ushers, Clubhouse, work projects, etc.): _______________________ __________________________________________________________________________________________
Thank you for giving ACTS the opportunity to reach out with God’s love Phone the Church Office at 541-926-2291 and ask for ACTS Ministry or Ext. 247
Assistance given to Applicant (If none, why not?): Description
Amount
___________________________________________
____________________________________
___________________________________________
____________________________________
___________________________________________
____________________________________
Authorized Signature(s): ___________________________________________
____________________________________
___________________________________________
____________________________________
Steps for Assistance: 1. Application You can get an application by: • Printing one from www.hope.church • Calling the Church Office 541.926.2291 and having one mailed to you • Picking one up at the Church Office Monday-Thursday 8-4:30 or Friday 8-12 • Choosing one from the Sanctuary foyer literature racks 2. Fill out ACTS Application for Assistance 3. Call the Church Office 541.926.HOPE (4673) ask for ACTS Ministry 4. Meet with ACTS committee member to turn in application and qualify 5. Assistance days are Monday and Thursday, 9-11:30 am What if I need help right away? We may be able to give immediate assistance if you qualify What do I need to bring to the interview? You will need to bring: • •
Rent or mortgage payments, billings, utility notices Other documented proof of need
What can I expect in the application process? Appointment process: • • • •
Review applicant’s application Determine and verify need if possible Prayer Offer assistance
After assistance has been given, there will be a follow-up call or visit.
APPLICANT’S INFORMATION AND ASSISTANCE NEEDS ARE KEPT CONFIDENTIAL
ACTS Ministry Acts of Caring Through Serving
Date: __________________________ Financial aid, as well as food and other services, are given generously to those who are a part of our church family Those not a part of our church family are first referred to other appropriate community agencies before we evaluate any needs that we may be able to meet. Applicant’s Name: ________________________________________ Phone: ___________________________ Street Address: ___________________________________________ City: ____________________________ Family Information List members living in your household and specify relationship: ____________________________________
_________________________________________
____________________________________
_________________________________________
Financial Status Present source(s) of income: __________________________________________________________________ _________________________________________________________________________________________ Current Needs I need help with: ___________________________________________________________________________ _________________________________________________________________________________________ Cause of your present need: __________________________________________________________________ Have you received other services within the last 30 days (health care, delivered meals, etc.)? Y N If so, who from? ___________________________________________________________________________ Do you have an eviction or foreclosure notice? Do you expect to get a utility shut-off notice?
Yes Yes
No No
Does anyone in your household have health insurance now?
Yes
No
How did you find out about ACTS Ministries? ____________________________________________________ If referred by someone else, please give the name of the person or organization: _________________________ __________________________________________________________________________________________
My involvement at Hope Church Involvement is more than just Christmas and Easter attendance. It is a week-by-week commitment to Jesus that says, “I believe in the God-given ministry of this church and support it with my time, talent, prayers and resources.” I am involved in the life of the church in the following areas: Church attendance (check only the areas of regular attendance): None
Sunday AM
Sunday PM
Wednesday
Other areas I am involved in (for example Ushers, Clubhouse, work projects, etc.): _______________________ __________________________________________________________________________________________
Thank you for giving ACTS the opportunity to reach out with God’s love Phone the Church Office at 541-926-2291 and ask for ACTS Ministry or Ext. 247
Assistance given to Applicant (If none, why not?): Description
Amount
___________________________________________
____________________________________
___________________________________________
____________________________________
___________________________________________
____________________________________
Authorized Signature(s): ___________________________________________
____________________________________
___________________________________________
____________________________________
