Nicene Covenant Church
(Grace Community Schools)
Application for Financial Assistance
In order for your application to be considered you must currently be employed. Thank you !
Personal Information
Applicant Name
Address
City, State, Zip
Home Phone
Cell Phone
Email Address
Social Security #
Marital Status
Number of Children (under the age of 18)
Co-Applicant Name
Employment Information
Employer Name
Work Phone
Income Information
Weekly Income
Child Support
Other Income
By my signature below, I authorize the Financial Assistance Directors to contact my employer (s) to verify employment. I also understand that I may need to provide proof of employment income and my information will need to be reviewed every 3 months. I understand that by failing to produce income verification and keeping my account in good standing I may be dismissed from the assistance program.