Financial Aid

Request Form

Name

First Name

Last Name

Email

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

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

Include the amount you are requesting and ways the church can pay it, should funds be provided.

Why are you in need? What events have led to you needing help?

What steps have you taken to resolve the situation?

Should financial aid be provided to you by the church, how do you plan to cover similar expenses in the future?

Do you go to church? If so, which one?

If you go to a church other than New Heights, have you spoken to the leadership about your need? If so, what did they advise you to do?

List all Churches/ Agencies/ Organizations you have contacted requesting assistance for your need.