Diocesan Contact's Form for a Congregation Needing Assistance and Willing to Receive Help

     
   
  CAUTION: Please use the "Tab" key to move between fields. Hitting the "Return" or "Enter" key will result in the form being submitted before completion.
 
  1. Name of your congregation and diocese:
  2a. Street address:
  2b. City, State, ZIP for above
  3. Church contact information  
   
Office phone
Office FAX
Office email
Church web site address (if any)
  4. Name of Rector:
  5. Name of Key Contact Person for matters regarding the partnership
  Key Contact's
Primary phone
Secondary phone
FAX
Email address
  6. Church membership : members. Average Sunday attendance:
     
  7. Please succinctly sum up the damage sustained by your congregation:
  8. What would be the most helpful assistance you could use from a strong partner congregation(s) to assist you in getting back in operation?
 
(a)
Financial assistance in the amount of Please give your reasons for arriving at this approximate amount and how would the money be used?
 
(b)
Other desired assistance (list reasoning beside each)
Physical laborers to
Pastoral and/or mental health counselors to
  9. Readiness status of congregation to receive some or all of the above assistance:
 
  (a) Have you discussed these needs with your bishop and if yes, is he in agreement of your assessment of needs and readiness to receive partnership assistance? (Please elaborate)
  (b) Has your rector, vestry, other church leadership, et al. discussed and are in concurrence of your need to move forward with receiving partnership assistance? (Please elaborate)
  (c) If you have answered yes to 9 (a) and (b), when do you wish to begin the partnership and what first steps are you ready to begin?
When: First steps:
   
 
     
  Click here to submit >>       (Print out the "Success" page for your records)