Project Restoration

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All required fields will be marked with an *

Personal Information *

Your Name



Home Phone
Cell Phone/Pager
Best way to reach you?

Ministry Information *

In what area of the ministry do you currently serve?

Estimated volunteer hours spent per week working for the church?
Does your household tithe regularly?
Yes No
Did your family bring one weeks salary as an offering for first fruits?
Yes No

Financial Information *

Gross annual household income (including bonuses and side income)

Total debt (excluding mortgages and car notes)

What is the total amount of your family's past due bills (including mortgages, rent, car notes, tuition, etc.)?
Is your family willing to submit to full disclosure of income and debts for counseling?
Yes No