Blonde girl in front of mountain view.

COVID-19 Church Relief Fund Request

Name of Church * Required
Name of requestor * Required
First Last
Phone * Required
Church address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email * Required
Pastor's Name * Required
First Last
Church Clerk, Treasurer, or Elder’s Name * Required
First Last
*Must be endorsed by two persons; Pastor and church clerk, treasurer or elder.
*Check will be made out to the Church not an individual.