LoveHopes Emergency Assistance Application

Purpose:

LoveHopes provides limited emergency assistance to eligible families for needs such as rent, utilities, gas cards, diapers, and other crisis-related expenses. Completing this application does not guarantee assistance. All information provided will be reviewed by our team.

Applicant Information

First name

Last name

Phone

Child 1 Full Name

Child 1 Age

Child 1 Grade in School (if applicable)

If your child is age 0–10, please include: Favorite Color, Characters they love, Favorite Activities or Toys

If your child is over age 10 please include: Favorite Fast-Food Restaurant, Interests or Hobbies

Child 2 Full Name

Child 2 Age

Child 2 Grade in School (if applicable)

If your child is age 0–10, please include: Favorite Colors, Characters they love, Favorite Activities or Toys

If your child is over age 10, please include: Favorite Fast-Food Restaurant, Interests or Hobbies

Child 3 Full Name

Child 3 Age

Child 3 Grade in School (if applicable)

If your child is age 0–10, please include: Favorite Color, Characters they love, Favorite Activities or Toys

If your child is over age 10, please include: Favorite Fast-Food Restaurant, Interests or Hobbies

Child 4 Full Name

Child 4 Age

Child 4 Grade in School (if applicable)

If your child is age 0–10, please include: Favorite Color, Characters they love, Favorite Activities or Toys

If your child is over age 10, please include: Favorite Fast-Food Restaurant, Interests or Hobbies

How can we come alongside your family in prayer this Christmas?