TBCF Benevolence Application

Benevolence Guidelines

The Bridge Christian Fellowship assists with utility cut-off notices. TBCF does not assit with hotel rentals or rent. We also do not give out cash.

TBCF has a bill pay limit of $150 per individual per calendar year.

Please fill out this form for assistance.

Section 1 - Personal Information

Name (Please provide your legal name)

This address will receive a confirmation email

Phone

Address (Please provide your permanent address or where you are currently staying.)

Date of Birth (MM DD YY)

Marital Status

Married Widowed Divorced or Separated Single

Please list the names and your relationship to all the people in your household. Please include the ages of children.

Section 2 - Financial Information

Are you currently employed?

Yes No

If yes, what is your current job position?

If no, how long have you been unemployed?

If you are unemployed, are you currently seeking employment? Yes No

Are you receiving governmental financial assistance?

Yes No

If yes, what is the total amount received per month?

What is your total monthly income? Please also include total household income if you are not the only employed individual:

Section 3 - Details of Request

What is your situation? Please provide a brief description of your current circumstance.

What is the amount of your financial need?

Have you received a cut off notice for a bill?

If so, when is the cut off date? MM DD YYYY

What is the minimum payment to prevent cut off? You can typically find this amount on the top portion of your bill (or under disconnect notice).

What events led to your request for assistance? Please also include a brief timeline of how you have arrived to your current circumstance.

Are you usually able to pay the bill?

Yes No

What is the reason for the lack of funds?

Section 4 - Additional Information

Are you a member of The Bridge Christian Fellowship?

Yes No

Do you attend another church? Please name church if applicable.

Have you approached another church/churches for assistant?

Yes No

Please describe the outcome.

Have you seen a financial counselor?

Yes No

If so, with whom and when?

How did you hear about The Bridge Christian Fellowship?

Please feel free to leave any additional comments or information that may be helpful as we review your case:

Section 5 - Required Information

Please email a copy of your cut-off notice to info@thebridgecf.org.

TBCF Benevolence Application

Description

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