COS Benevolence Fund Request

Thank you for your application to the COS Benevolence Fund. The committee will review all applications with prayerful consideration. Submission of an application does not guarantee approval.
Please expect a response within 1 to 2 weeks regarding the status of your application. If you have any other questions, please contact us at: benevolencefund@churchofsouthland.com.
God bless you,
Benevolence Fund Committee

Your name *

Email address *

Address

Phone number

Other Information

Age of Applicant *

Number of family members living with you & their relationship to you: *

Do you attend Church of Southland? *

Yes

If yes, how long have you attended Church of Southland?

Please describe your reason for Benevolence Fund request. *

What other financial aid (e.g., family, friends, other sources) have you sought out prior to filling out this Benevolence Fund application? Please describe below. *

What would you need this fund for? *

Certification

The above information is true to the best of my knowledge. The church has my permission to verify any of the above information to determine assistance. I understand that the church does not bind itself to assist me. *

Please write out your name below as an electronic signature.

Today's Date *

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