Benevolent Request Request FormYour Name *Your Email *Your Phone Are you filling this out on behalf of yourself or someone else? *YourselfSomeone else within Grace FellowshipSomeone else outside of Grace FellowshipRecipient Name If for someone else, please fill their name out here.Recipient Information Please fill out the following in regards to the recipient.Address Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryPhone Email Gospel Community Leader *Amount or Items Requested *Purpose of Request *What events led to your needing assistance? *Have you received assistance from Grace Fellowship in the past? *YesNoIf yes, please explain what and when Employment HistoryPresent/most recent employer(s) *Phone number of most recent employer(s) *Reason for leaving if no longer employed If you are unemployed, are you currently seeking employment? *Not ApplicableYesNoHow long have you been unemployed? Reason for Unemployment What steps are you taking to seek employment? Financial InformationHave you sought out financial counsel within the last 6 months? *YesNoIf so, with whom, or if not, why not? *What steps are you taking to improve your present situation? *Please provide 3 references along with their contact info: *With our limited resources, why do you believe the church family should support this request? *Final ChecklistI am an active partner of Grace Fellowship *YesNoI generously give of my time to serve the body of Grace Fellowship in the following ways: *I generously give financially on a regular basis to Grace Fellowship to advance our kingdom mission. *YesNoI am meaningfully connected in the following Gospel Community: *Gospel Community References Have your Gospel Community leader and one other individual from your Gospel Community group send email recommendations to: info@gracesask.comAdditional Comments VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>:
