South Buckhannon Mission Church

152 Randolph St., Buckhannon, WV 26201

Benevolent Ministry

Benevolent Policy:

*SBMC members are given first priority.

*We only accept one application per year from an individual/family.

*No cash disbursements are made.

*Proof of need is required.

*No applicant can receive more than $300 in one year(excludes members).

* Financial assistance can only be made to third parties and will be mailed directly to them. This includes utility companies such as electric, gas, or water. Rent will be paid to the landlord. Other needs may be met on an individual basis.

*Decisions will not be made before the next scheduled trustee meeting except in case of emergencies.

*Applications must be signed by the applicant and spouse, when applicable.

*Our churches primary responsibility is your spiritual wellbeing.

Please know that we are praying for you.

Sincerely,

The Trustees of SBMC

SBMC Benevolence Request Form

*all questions must be answered or application is voided

Date:______

Name:______

Address:______

______

Phone:(home)______(cell)______

Married_____ Single_____ Other_____ How many people live in your home:______

List all persons residing in your home:

Name:______Age:______Relationship:______

Are you currently employed: yes_____ no_____

Current employer:______Address:______

If married, is spouse employed: yes_____ no_____ Employer:______

Total household income monthly:______

Is anyone in your household receiving disability or federal/state assistance:______

What type and what is the monthly amount:______

Checking account balance:______

Savings account/additional monies available:______

Do you rent or own your own home:______

Monthly rent/house payment amount:______

List utilities/monthly expenses and average amounts:

1.______

2.______

3.______

4.______

5.______

6.______

What is your need today and what specific help are you requesting?

______

Are you a member of South Buckhannon Mission Church?______

If no, do you have any family members that attend SBMC and who?______

Do you attend church elsewhere? Where?______

Have you been helped previously by SBMC and when:______

Have you asked any other agencies for assistance? Please provide name and phone# if yes.

______

If assisted by us, how will you pay for this next month or when needed?

______

Benevolence funds are limited to the church's ability to pay and are at the discretion of the trustee board. A benevolence form must be completed and signed prior to any assistance given and is limited to once a year. Any deviations to this policy must be approved by a trustee majority. I have read and understand this form and affirm that my answers are complete and accurate to the best of my knowledge.

Signature:______

If married, signature of spouse______

*PLEASE ATTACH PROOF OF NEED (eviction notice, copy of bill with account number, etc.)

______

Date of approval:______

Approved by:______

Specific need and how met:______

______