Cross Timbers Church

Benevolence - Request for Assistance

Request For Assistance Guidelines

1. We primarily assist with rent, mortgage and utilities. We may consider other needs if we deem them to be a necessity. 

2. No cash will be given out at any time for any reason. Cross Timbers Community Church (CT) will submit payment directly to the company to which the payment is owed.

3. If assistance is approved, you may still be responsible for a portion of your rent, mortgage, utilities, or car repair first. 

4. Documentation will be required to be submitted to before consideration of anykind can be processed. 
Documents needed are: 
  • Budget Sheet
  • A copy of the full bill
  • A copy of your photo ID
  • A copy of your complete lease agreement or mortgage statement (if requesting assistance with rent or mortgage)

Please complete all of the following fields, then click submit to complete your application.

Applicant Contact Information

*Address Line 1
Address Line 2
*Zip/Postal Code
*Date of Birth:
*Marital Status:
Personal Information History
Have you or anyone in your house recently been arrested and/or convicted of a crime?
If Yes, please briefly describe.
Are you currently employed?
If Yes, please provide name of current employment(full and/or part time).
How long have you been at your current place of employment?
Name of past place of employment (full and/or part time)
Past place of employment: Dates of employment
Past place of employment: Reason for leaving
Who referred you to Cross Timbers?
Have you been assisted by any other church, agency or organization?
If Yes, provide the name of organization as well as the assistance received and date of assistance received.
Household Structure
Do you live alone?
Please provide the following information on all persons, other than yourself, living in your home with you.
*Date of Birth
*Are they working and/or contributing any money to the household expenses?
*Person 1 - Full Name
*Person 1 - Date of Birth:
*Person 1 - Are they working and/or contributing any money to the household expenses?
Person 2 - Full Name
Person 2 - Date of Birth:
Person 2 - Are they working and/or contributing any money to the household expenses?
Person 3 - Full Name
Person 3 - Date of Birth
Person 3 - Are they working and/or contributing any money to the household expenses?
Church Affiliation
Do you call Cross Timbers home?
What campus do you attend?
Do you have a church home other than CT? If Yes, where?
Your Situation
Please describe the situation that has caused you to ask for assistance at this time. 
What is your need today?
If you have more than one need; from the list to your right please, by priority, list your type of need.
(EX: My needs in priority list - 1. Rent 2. Utilities 3. Utilities)
Documentation required before consideration.

*Budget Sheet
*A copy of the full bill that you are requesting assistance with and/or other documentation
*A copy of your photo ID
*If you are needing assistance with rent or mortgage; please upload a copy of your complete lease agreement or mortgage statement.
*I understand I will have to provide correct and full documentation before I can be considered for assitance from Cross Timbers.
Please email all documentation in their entirety to:
*I hereby authorize the release of information to Cross Timbers Community Church (CT) to receive the assistance I am requesting.  I further certify the information I have stated is true and correct and that all income is reported.  I understand CT may verify the information on this application and that deliberate misrepresentation of information may subject me to denial of assistance/services.
*I give permission for CT to discuss my case with other agencies, businesses, churches, attorneys, individuals, and any other deemed necessary to verify application information and/or identify additional sources of assistance.  I understand that all information will remain as private as possible within these entities. 

*I understand that the assistance I am applying for may not be approved.
*Please enter your full name for this acknowledgment statement. 
I have read, understood, and agree to the policies above regarding the Release Of Information.
If CT assists you please consider a financial contribution when you are economically capable.  This ensures that others can be helped when the need arises.

Please enter your initials for each statment as acknowledgement that you have read and understand each statement. 
*Date Signed: