COVID-19: Local Church Assistance Request Form Church Name*District*-- Select A District --BeaconCapitalCorridorFairwayGatewayHarborHeritageSoundPastor'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.Paycheck Protection Program (PPP)*Have you applied for a Paycheck Protection Program forgivable loan through the Small Business Administration?YesNoDate Applied for PPP*What date did you apply for the Paycheck Protection Program? Date Format: MM slash DD slash YYYY Some assistance funds listed below will be available only after application for PPP assistance. Learn more about the Paycheck Protection Program (PPP) on our COVID-19: Local Church Assistance – What Should We Do Now? page.Type of Assistance*What type of assistance do you need? Missions Grant Church Operating Expense Pastor Compensation Expense Health Insurance Premiums – Church Portion Pension Contributions – Church Portion Other Missions Grant Description*Describe how your church members will serve your community during this crisis.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 Description*Please describe the need.Church Operating Expense Amount*How much are you requesting?Pastor Compensation Expense Description*Please describe the need.Pastor Compensation Expense Amount*How much are you requesting?Health Insurance Premiums – Church Portion Description*Please describe the need.Health Insurance Premiums – Church Portion Amount*How much are you requesting?Pension Contributions – Church Portion Description*Please describe the need.Pension Contributions – Church Portion Amount*How much are you requesting?Other Description*Please describe the need.Other Amount*How much are you requesting?Spending Outline*Give a brief outline of how you will expend the funds.Additional InformationWould you like to add any additional information about this request?EmailThis field is for validation purposes and should be left unchanged.