Financial Need
First Name
First Name cannot contain special characters such as quotes, parentheses, etc.
First Name cannot contain emojis or special fonts.
First Name is required.
Last Name
Last Name cannot contain special characters such as quotes, parentheses, etc.
Last Name cannot contain emojis or special fonts.
Last Name is required.
Email
Email address is not valid
Email is required.
Campus
Windmill
Midtown
Highlands
Online
Campus is required.
Mobile Phone
Birthdate
Birthdate is required.
Marital Status
Married
Separated
Single Again (Divorced)
Single
Marital Status is required.
If married, spouse's name
How long have you been attending The Crossing?
How long have you been attending The Crossing? is required.
Are you in a Small Group?
Yes
No
Are you in a Small Group? is required.
If yes, who is your leader?
What ministries have been involved in at The Crossing?
Have you received assistance from The Crossing in the past?
Yes
No
Have you received assistance from The Crossing in the past? is required.
What is your total family income for the month?
What is your total family income for the month? is required.
Are you employed?
Yes
No
Are you employed? is required.
If yes, who is your employer?
Are you currently receiving assistance from any other source?
Yes
No
Are you currently receiving assistance from any other source? is required.
If yes, please give source of assistance and amount/type of assistance you are receiving.
Tell us About What's Going on and How We MIght Help
Please reduce the length of Tell us About What 's Going on and How We M Ight Help to 500 characters.
I agree that the information I have provided is true to the best of my knowledge. The church has permission to verify any of the information to help in determining my request for assistance.
I agree
I agree that the information I have provided is true to the best of my knowledge. The church has permission to verify any of the information to help in determining my request for assistance. is required.
I release The Crossing, its employees, agents or other persons, and organizations on its behalf, from any liability out of, or resulting from this application.
I agree
I release The Crossing, its employees, agents or other persons, and organizations on its behalf, from any liability out of, or resulting from this application. is required.
Electronic Signature
Electronic Signature is required.
Today's Date
Today's Date is required.
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