Request AssISTANCE

Grace Ministries

Financial Assistance Application

This field is for validation purposes and should be left unchanged.

Applicant Information

Name(Required)
Date of Birth
Address
Email(Required)

Household Information

Please list all individuals residing in your household, including yourself.

Income Information

Provide documentation for all income sources listed below.

Monthly Expenses

Please provide your household’s average monthly expenses.

Assistance Request

Supporting Documentation

Drop files here or
Accepted file types: jpg, png, pdf, Max. file size: 6 MB, Max. files: 5.
    Please attach copies of the following documents: Recent pay stubs or income statements (last 3 months) | Most recent tax return | Proof of residency (e.g., utility bill) | Identification (e.g., driver’s license, state ID) | Any other relevant financial documents

    Supporting Documentation

    Consent(Required)
    Clear Signature
    Date(Required)
    Grace Ministries

    Your Path to Assistance

    Frequently asked questions

    What is the Intake Process?
    Every client will have an intake appointment with one of our intake specialists. An intake form will be completed to determine client needs; appropriate plan of action and service agreement will be outlined. Client will sign a service agreement with Grace Ministries.