0%
Worksheet

Angel Fund Request

Use this form to request financial assistance with dues or fees. Form must be completed in full.

Submission of this request does not guarantee approval. After a review of this request, you will be notified of the decision. 

NOTE: Please print the completed form and mail it to:

Alliance of Divine Love, Inc.
PO Box 238
Flat Rock, NC 28731

1. ➜

Reason for Angel Fund Request

2. ➜

Additional Explanation

Please provide further explanation for your reason for submitting this request.

3. ➜

Email Address

4. ➜

Best phone number(s) to reach you

5. ➜

Ordination Date

6. ➜

Chapel #

7. ➜

Chapel Name

8. ➜

EIN #

9. ➜

Chapel Physical Address

10. ➜

Mailing Address

11. ➜

Minister Name/Signature

Entering your name here also acts as your digital signature.