Benevolence Request - LaFayette Church of God

Do you attend LaFayette Church of God? *

Yes

No

Address *

Phone number *

Drivers License or State ID Number *

Birthdate *

Type And Amount Of Need Requested: *

Ex. Food, Utilities, Rent, Clothing, etc.

Reason For Request: *

What events have led to this need? How could LaFayette Church of God best help, if able?

By submitting this form you guarantee that the information provided above is accurate and true. You also understand that benevolence assistance is a one-time gift and may not be reapplied for, for a period of at least 6 months.