COVID-19: Local Church Grant Request Form - Treasurer's Office

Church Name*
Please select your church.
Organization Name*
District*
Pastor's Name*
First Last
Your Name*
First Last
Your Email*
What is a valid email address that you regularly check?
Enter Email Confirm Email
Your Phone*
Please enter your best contact phone number.
Type of Grant*
What type of grant would you like to request? Select all that apply.

Up to three months of church contributions may be considered for Health Insurance or Pension grants.
- Missions Grant
- Church Operating Expense
- Pastor Compensation Expense
- Health Insurance Premiums – Church Portion
- Pension Contributions – Church Portion
Missions Grant Description*
Describe how your church members will serve your community during this crisis.

This grant is to support ongoing pandemic-related community outreach or new outreach opportunities.
Mission Grant Amount*
How much are you requesting?
Mission Partner*
Who will you partner with to meet the needs of your community?
Church Operating Expense*
Please indicate the operating expense(s) for which you are requesting assistance. You may choose multiple items.
- Church: Electric
- Church: Gas
- Church: Phone/Internet/Cable
- Church: Water
- Parsonage: Utilities
- Other
Church: Electric Amount*
Enter the monthly amount.
Church: Gas Amount*
Enter the top-off / refill amount.
Church: Phone/Internet/Cable Amount*
Enter the monthly amount.
Church: Water Amount*
Enter the monthly amount.
Parsonage: Utilities Amount*
Enter the monthly amount.
Other Expense Description
Other Amount*
Enter the monthly amount.
Church Operating Expenses - Total*
Pastor Compensation Expense Description*
Please describe the need. This grant is for compensation for the pastor(s) only, not other members of the church staff.
Pastor Compensation Expense Amount*
How much are you requesting? Please enter the monthly compensation amount.
Health Insurance Premiums*
Is the grant recipient currently enrolled in a Conference insurance plan?
- Yes
- No
To apply for the Health Insurance grant, recipients must be enrolled in a Conference insurance plan.
Health Insurance Premiums – Amount*
Indicate how many months of the church's portion of the premiums, up to three months.

NOTE: This is a one-time grant request.
- One Month
- Two Months
- Three Months
Pension Contributions – Amount*
Indicate how many months of the church's portion of the pension contribution, up to three months.

NOTE: This is a one-time grant request.
- One Month
- Two Months
- Three Months
Spending Outline*
Give a brief outline of how you will expend the funds.
Additional Information
Would you like to add any additional information about this request?
Name
This field is for validation purposes and should be left unchanged.