Guidelines:

·         A copy of your driver's license or picture ID is required.
·         No cash is given. Payment is made directly to the debtor.
.         We assist with utilities, rent/mortgage, etc. We do not assist with hotel/motel room rent.
·         Checks or money orders must be picked up in person. They will not be mailed.
·         A maximum dollar amount has been established and will not be exceeded per request.
·         Assistance will only be offered once every six months.
·         No loitering is allowed.
·         Financial decisions will be made each Tuesday by our Financial Assistance Team. Please turn in your request by Monday afternoon to be considered for that week. You can turn in the request form:

o   in person to the church office
o   through the mail | 1330 Cobb Parkway N., Marietta, GA 30062
o   through email | office@mariettaadventist.org
o   through the online survey

·         Request forms must be filled out in their entirety and include a copy of your ID and the bill/lease you are needing assistance with. Incomplete forms will not be considered. No verbal requests will be considered.

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* 1. Tell us about you.

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* 2. What is your marital status?

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* 3. If applicable, what is your spouse's name?

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* 4. If applicable, what are your children's first names with ages?

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* 5. What is your current housing situation?

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* 6. Are you home bound?

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* 7. Are you currently employed?

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* 8. If yes, where? (Employer's name, address and phone number)

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* 9. If you are not employed, where and when (date range) did you last work and what was the reason for leaving?

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* 10. If you are currently seeking employment, what job are you hoping for?

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* 11. If applicable, is your spouse currently employed? 

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* 12. If yes, where? (Employer's name, address and phone number)

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* 13. If your spouse is not currently employed, where and when (date range) did they last work and what was the reason for leaving?

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* 14. If they are currently seeking employment, what job are they hoping for?

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* 15. What is your current annual household income?

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* 16. What is your monthly net income (what you actually have to spend)?

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* 17. What are your monthly household debts and expenses?

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* 18. Tell us about your current need and what you think helped to create it.

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* 19. Tell us things you've already done to correct the situation you are now in (asked family, made calls, used savings, taken on a 2nd job, etc.)

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* 20. Have you applied for assistance from Marietta SDA Church in the last 12 months?

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* 21. What specific assistance are you requesting?

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* 22. How much are you requesting?

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* 23. What is the name of the company (gas, car, leasing complex, etc.)?

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* 24. What is the due date of the bill you are asking assistance for?

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* 25. Which, if any, of the following programs do you participate in? (Participation will not disqualify you from receiving assistance.)

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* 26. Please upload a copy of your ID.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 27. Please upload a copy of the bill or lease that you are needing assistance with.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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