COVID-19 Relief Fund Application

IMPORTANT: Before completing this form, please note that the Covid-19 Relief is for Covenant Chapel members only. The purpose of the relief fund is to assist individuals with the purchase of food and/or medication. The beneficiary(s) must not be receiving employment income or financial assistance from the government

All fields are required to submit the form.

  1. Are you a member of Covenant Chapel?  
  2. What is your marital status?  
  3. Are you, or your spouse receiving employment income, or any financial assistance from the government?
  4. How many dependents are within your household?  
  5. If single, are you a student?  
  6. Are you working or receiving any financial assistance from the government?  
  7. Reason for Request:   
  8. If the answer to 1 above is Yes, do you receive emails from the church?  
  9. If answer to 8 above is No, would you like to start receiving emails from the church?   
  10. If the answer to 1 above is Yes, which Natural Group or department do you belong to:   
  11. Please provide the name and phone number of a church member that can attest for you: