Application

Bethlehem Baptist Church - Christmas Assistance Application 2024

*This application form is confidential. Please complete the application form below in its entirety. Incomplete forms will not be eligible for consideration. Application Deadline: Sunday, November 25, 2024. (No exceptions)

Eligible Recipients: This year's program is open to EVERYONE. If you / and or yourself has been faced by any challenge that may prevent you to provide your family with the resources for Christmas you are eligible to nominate that person or yourself for this years Holiday help. We're praying that those nominating or applying will be honest for this is to benefit someone truly needing assistance this holiday season. Selected recipients will be notified of the date to meet with leaders to receive this years blessing.

Brief Assistance Application
*Denotes Required fields.

* Indicates required field

Are you nominating a family? *

Yes No

I am nominating myself? Need Based *

Yes No

If nominating a family please type your full name. If not continue to recipients information. *

Recipients Full Name (First & Last Name) Head of Household *

Recipients Date of Birth. Example: MM/DD/YY *

Best number the recipient can be reached at? *

Recipients Full Home Address (Street, City, State, Zip) *

Recipients Household Income? *

$ to $5,000 Year $5,000 to $15,000 Year $15,000 to 25,000 Year $25,000 to $35,00 Year

List Recipient's Children in the household only. List full name, age, sex: boy or girl. Example: John Doe, Age: 7, Boy *

Give brief summary of why you think the recipient is deserving of this assistance? *

Submit

Bethlehem Baptist Church - Christmas Assistance Application 2024

Brief Assistance Application *Denotes Required fields.

#2025 #EDIFYING​We Would Love to Have You Worship With Us Soon!

Brief Assistance Application
*Denotes Required fields.

#2025 #EDIFYING
We Would Love to Have You Worship With Us Soon!