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LOVING HANDS APPLICATION

Complete the information below to apply for assistance through the Loving Hands benevolence program. A Christian Services representative will follow up with eligible applicants to review responses and ask for additional information. 

Please Allow Up to 5 - 7 Business Days for the application to be processed and to receive the decision. ​
 
All applications will only be considered complete if every question is answered and all files are attached. Any incomplete applications cannot be considered for assistance.

BASIC INFO

Relationship Status

Select an option

APPLICANT CONTACT INFORMATION

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DEMOGRAPHIC INFORMATION

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Race/Ethnicity (Select all that apply)

CHURCH INFORMATION

EMPLOYMENT INFORMATION

Current Employment Status (Select all that apply)
Do you qualify for Unemployment
Upload File

ADDITIONAL INCOME INFORMATION

List all sources of income within the household and the coordinating amounts per month from everyone in the household (e.g. salary, unemployment, child support, social security, disability, food stamps, etc.)

GOVERNMENT BENEFITS

RISK FACTORS

Select at least one benefit that you receive.
Select at least one

ASSISTANCE

Upload File

Thanks for submitting!

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