Request Assistance — BEARING THE BURDEN MINISTRIES

Our primary goal at Bearing the Burden Ministries is to be a blessing to those facing financial uncertainty and needing help to provide basic needs for their family. While we desire to help as many people as possible, with limited resources we must be selective on who specifically we choose to help. If you desire assistance, please fill out the application below.

*Please note: This is an application and not everyone that applies will receive assistance. Every application will go under a review process and can take up to 2 weeks before a decision is made.
If you do not receive a response within 2 weeks, please email us at bearingtheburdenministries@gmail.com to check the status of your application.

Legal Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Driver's License or State Issued ID #

Marital Status

If Married, Spouse's Legal Name

First Name

Last Name

Spouse's Driver's License or State Issued ID #

If Unmarried, Number of Legal Adults(18+) Living With You

If You Answered 1 or More, Please List Their Legal Names & ID #'s

Number of Children Living with You

If You Answered 1 or More, Please List the Name, Age, and Gender of Each Child

Have You or Anyone in Your Household Been Convicted of a Felony in the Last 5 Years?

If Yes, Please List All and Provide Details

Employment Status

If Employed, Please Provide Details of Employment. If Unemployed, Please Explain Why and Any Current Efforts to Seek Employment

If Anyone in Your Household is Employed, Please List All and Provide Details

Monthly Household Income

Are You Currently Receiving Assistance from Any Other Program, Institution, Non-profit, Church, Government, or Child Support?

If Yes, Please List All and Provide Details of Each

Please Provide a Brief Explanation of Your Current Situation and Why You Are Requesting Assistance

Are There Any Specific Needs You Are Seeking Assistance For?

(Listing needs here does not necessarily mean we will be able to cover these. If they do not fall into the criteria of areas we are able to help with, we will seek other means to provide assistance.)

Terms and Conditions

By checking this box, I acknowledge this is only an application and Bearing the Burden Ministries has the right to decline this application for any reason they see fit. I also acknowledge that Bearing the Burden Ministries is a Faith-Based, Christian non-profit ministry and may choose to decline this application based on any information obtained that contradicts its statement of faith. I also acknowledge that Bearing the Burden Ministries is NOT required to provide a reason or explanation for declining this application. Furthermore, I agree to not pursue any legal action against nor bring a lawsuit against Bearing the Burden Ministries or any of its officers, employees, or board members if this application is declined.

By checking this box, I attest that all of the information provided in this application is 100% accurate. If at any time any of this information is found to be untrue, the application will be immediately declined and assistance will be stopped immediately if already in progress. If assistance is withdrawn for this reason, I agree to not pursue legal action nor bring a lawsuit against Bearing the Burden Ministries or its officers, employees, or board members.