Benevolence Information Sheet

This form must be filled out prior to the pastor and benevolence committee members assessing your request. Please answer every question to the best of your ability. The committee will go over this form (including questions left blank) and try to answer any questions you might have. Information on this form will remain confidential, except when necessary to inform pastoral staff. Information will only be used for benevolence purposes.

PLEASE NOTE: Destiny members and regular attendees are given priority in benevolence requests. Outside requests are given consideration on a case-by-case basis, but there are other organizations in the region that we partner with that would likely be better equipped to assess and meet those needs.

Your name *

Last name

Email address *

Personal Information

Today's Date:

Address

Country

Street address

Apt/unit/box (optional)

City

State

Postal code

Phone Number

Phone type

How long at this address:

Previous address:

Are you?

Married

Single

Divorced

Separated

Widowed

Name of Spouse:

Address of spouse, if different from above:

Phone Number

Phone type

Email:

Children

Yes

Names and ages of children living at home:

Church Information

Are you a member or regular attendee of Destiny Foursquare Church?

Yes

If not, where do you regularly attend church?

How long have you been attending Destiny?

How did you hear about Destiny?

Do you attend a support group, class, Connect Group, or Bible study at Destiny?

Yes

If yes, which one?

Leader's Name:

Are you actively serving at Destiny Foursquare Church in any capacity?

Yes

Which ministry?

Leader's Name:

Employment

Are you currently employed?

Yes

Name of Employer/Company

Address

Country

Street address

Apt/unit/box (optional)

City

State

Postal code

Phone Number

Phone type

Email:

Supervisor's Name

Phone Number

Phone type

Do you give permission to call your employer?

Yes

How long employed there?

Type of work/position:

Name of previous employer/company:

Address

Country

Street address

Apt/unit/box (optional)

City

State

Postal code

Phone Number

Phone type

Supervisor's Name

Benevolence Request

What kind of help do you need? What is the request for? Please be specific, as to the amount you are requesting. And, if it is for a bill, please let us know who will be paid.

Has Destiny Foursquare Church helped you through benevolence support before? If yes, when and for what reason?

Who else have you contacted for help? (i.e. family, friends, other churches or community agencies)

Other Information

Thank you for completing this form. Upon submission, it will be forwarded to the benevolence committee for assessment. They will then contact you if an interview is necessary. They will also discuss other resources such as financial or vocational counseling, classes or support groups, and other community services. Destiny Foursquare Church will not give direct cash/check but may help by way of food, store coupons, vouchers, help with utility bills, etc. (praying directly to the company in your name). In general, Destiny is not able to help with paid lodging (hotel/motels) for liability reasons. Destiny is not able to make loans of any kind.

God bless,

The Benevolence Team at Destiny

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Destiny Foursquare Church
destiny@destiny4square.org
605.348.7958