TO APPLY FOR ASSISTANCE, PLEASE COMPLETE THIS FORM. If you have any questions, please email us at Vetting@unitycharlottenc.org

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Amount Requested

Message/Comments:

Are you currently employed"

Yes

Does your budget cover your expenses?

Yes

If yes, why are you needing assistance?

If no, how are you planning to cover this expense moving forward?

What resources have you explored before reaching out to the Vetting Committee?

How many adults and children are in your household?

Are you available to volunteer at Unity Church or if not local, provide community service?

Yes

Provide three (3) denial letters from community services requested.

All payments for outstanding bills will be paid directly to the billing company. Please provide contact information, account number and all information needed for payment.

Location

Times

Contact