CBC Assistance Request Form

CBC - Assistance Request Form

This application must be completed entirely or it could delay consideration. The applicant MUST call the Deacon of the Week at (859) 806-9223 to setup an appointment immediately after completing this application. Completion of this request does not guarantee assistance. Applicants are encouraged to first seek assistance from community organizations and family members.


*Marital Status
*Are you a member of the church?
*Are you a consistent tithe payer of this church?

Source of Income

Please indicate all sources of income and frequency of which income is received. If you have a spouse please include their sources of income in your calculations also. For each source of income on the list, please indicate how much and how often (weekly, bi-weekly, monthly) you receive it.


Average Monthly Expenses

Please list all your average monthly expenses.


*Do you rent or own your home?

References

Please list at least 2 family references


Description of Need

Indicate what items you need assistance with today.



What is your need?
*Have you been helped previously by the church?

Bill Payment Information

If you are requesting a bill payment, please provide the following information. Checks are written to companies ONLY, if an individual landlord is the payee the church must have the person's social security number or tax ID number.


Submit Request



CONSOLIDATED
BAPTIST CHURCH

1625 RUSSELL CAVE RD.
LEXINGTON, KY 40505
(859) 299-8559

SERVICE TIMES

SUNDAY SCHOOL
9:25 A.M.

SUNDAY MORNING WORSHIP
11:00 A.M.

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WEDNESDAY PRAYER
& BIBLE STUDY
11:00 A.M. & 6:00 P.M.

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