Benevolence Request Benevolence Requestors must be a NBC member for at least 6 months prior to the request for assistance and be a contributing member who is active and in good standing. All others may be referred to other agencies i.e., CCA, Salvation Army, etc. Please be aware that you may be asked to complete more detailed questions when requested and it may take up to 4 days for request to be reviewed. Name First Last Date PhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Email Is your personal information updated in the church databaseYesNoName of Pastor, Elder, Ministry leader who can verify your need.*Our policy is to help people who are members for a minimum of 6 months. All others are referred to other agencies i.e., United Way, CCA, etc.I am not a member of New Beginnings ChurchI have been a member of New Beginnings Church for 6 months or moreI have not been a member of New Beginnings for 6 months or moreDescribe how you want New Beginnings to help you.Timeliness of the needEmergency- in desperate needImmediate- need money ASAPUpcoming needIf we assist you, how will you meet your needs in the future?BudgetYes I have a budgetNo I do not have a budgetYes I have completed our Crown Financial ClassNo I have not completed our Crown Finanacial ClassSignature*I agree to give my permission to New Beginnings Church to release and request information to help my case. This information is held in confidence unless deemed necessary to assist. I understand the Benevolence Team will discuss my request. Your signature must be included to consider your application.Specific dollar amount requested $0.00 Any additional information that you feel is necessary below.