Financial Assistance Grant Request

1. The Christian and Missionary Alliance has been blessed with matching grant funds to offer financial assistance grants to 25 pastors. Choose one of the following grants:

Medical Bill Assistance Grant up to $2,000 for pastors participating in the C&MA Health Plan who have unpaid medical bills. Be sure to explain your current need and the reason for the need and include the amount of medical debt you have incurred. Please enter an 'other' value for this selection.
Life Insurance to Protect Your Loved Ones for pastors who do not have life insurance and serve in churches with an annual church budget of $100,000 or less.Grant would cover the pastor’s premium for $30,000 of Basic Life Insurance as well as Long-Term Disability, plus up to $50 a month in funds toward voluntary life insurance for the pastor, spouse and/or children. Grant would cover the entire amount in the first year but would step down in subsequent years to assist the church in keeping insurance current: Grant Year 1 = 100%; Grant Year 2 = 75%; Grant Year 3 = 50%; Grant Year 4 = 25%. Church would complete a “Letter of Intent” committing to continuing coverage for its pastor with Alliance Benefits beyond the life of the grant.
Retirement Savings Jump Start Grant of $2,000 for pastors 50 years of age and over who haven’t saved yet for retirement, do not have a personal retirement account but agree to open a C&MA 403(b) retirement account. Additionally, your church must be willing to contribute at least $100 per month ($1,200 per year) from the church budget into this account beginning sometime in 2020.

2. Other Grant Criteria:

Space Cell	Yes	No
Pastor is credentialed with the C&MA and in active service.	Pastor is credentialed with the C&MA and in active service.: Yes	Pastor is credentialed with the C&MA and in active service.: No
2. Signed up at NAEfinancialhealth.org/cma and created an account to preview (with your spouse, if married) the Personal Finances course and the Generosity training sessions available to you and your board.	2. Signed up at NAEfinancialhealth.org/cma and created an account to preview (with your spouse, if married) the Personal Finances course and the Generosity training sessions available to you and your board.: Yes	2. Signed up at NAEfinancialhealth.org/cma and created an account to preview (with your spouse, if married) the Personal Finances course and the Generosity training sessions available to you and your board.: No
3. Chosen and talked with a designated lay leader that has reviewed this application, created his own account at NAEfinancialhealth.org/cma and previewed the available individual church board/leaders generosity training sessions and course.	3. Chosen and talked with a designated lay leader that has reviewed this application, created his own account at NAEfinancialhealth.org/cma and previewed the available individual church board/leaders generosity training sessions and course. : Yes	3. Chosen and talked with a designated lay leader that has reviewed this application, created his own account at NAEfinancialhealth.org/cma and previewed the available individual church board/leaders generosity training sessions and course. : No
4. Agree to start and finish the Personal Finances course (with your spouse, if married) within nine months if approved for a Financial Assistance grant.	4. Agree to start and finish the Personal Finances course (with your spouse, if married) within nine months if approved for a Financial Assistance grant.: Yes	4. Agree to start and finish the Personal Finances course (with your spouse, if married) within nine months if approved for a Financial Assistance grant.: No
5. Your designated church leader agrees to schedule a time in the coming months for your church board or 3 or more leaders to go through the Bless Your Pastor training session and finalize plans when to distribute the brochure to the families in your congregation, and receive a Pastor or Pastor (and staff, if applicable) Appreciation offering. Note: You and your church leader are also encouraged to consider using the other individual training sessions, 6-session Church Generosity course, or other NAE Financial Health resources in the future.	5. Your designated church leader agrees to schedule a time in the coming months for your church board or 3 or more leaders to go through the Bless Your Pastor training session and finalize plans when to distribute the brochure to the families in your congregation, and receive a Pastor or Pastor (and staff, if applicable) Appreciation offering. Note: You and your church leader are also encouraged to consider using the other individual training sessions, 6-session Church Generosity course, or other NAE Financial Health resources in the future.: Yes	5. Your designated church leader agrees to schedule a time in the coming months for your church board or 3 or more leaders to go through the Bless Your Pastor training session and finalize plans when to distribute the brochure to the families in your congregation, and receive a Pastor or Pastor (and staff, if applicable) Appreciation offering. Note: You and your church leader are also encouraged to consider using the other individual training sessions, 6-session Church Generosity course, or other NAE Financial Health resources in the future.: No
6. Understand you will receive the grant when we receive your course completion certificate for the Personal Finances.	6. Understand you will receive the grant when we receive your course completion certificate for the Personal Finances. : Yes	6. Understand you will receive the grant when we receive your course completion certificate for the Personal Finances. : No
7. Complete your online application at NAEfinancialhealth.org/cma and turn in an IRS W9 form.	7. Complete your online application at NAEfinancialhealth.org/cma and turn in an IRS W9 form.: Yes	7. Complete your online application at NAEfinancialhealth.org/cma and turn in an IRS W9 form.: No

3. How did you first hear about the Financial Health courses and grant?

4. Please provide the following contact information. All information is required. If not married, in the spouse boxes put the word: no *This question is required.

Space Cell	First Name	Last Name	Area Code/Cell	Email
Pastor	Pastor: First Name	Pastor: Last Name	Pastor: Area Code/Cell	Pastor: Email
Spouse	Spouse: First Name	Spouse: Last Name	Spouse: Area Code/Cell	Spouse: Email
Lay Leader	Lay Leader: First Name	Lay Leader: Last Name	Lay Leader: Area Code/Cell	Lay Leader: Email

5. Please provide the following church information. *This question is required.

Space Cell	Church Name	Worship Attendance	Annual Budget	Phone w/Area Code
-	-: Church Name	-: Worship Attendance	-: Annual Budget	-: Phone w/Area Code

6. Please provide the following personal information *This question is required.

Space Cell	Your Age	Pastor Salary (including housing allowance) from the church	Any additional household income sources? Please briefly explain source(s) and annual amounts
-	-: Your Age	-: Pastor Salary (including housing allowance) from the church	-: Any additional household income sources? Please briefly explain source(s) and annual amounts

7. Please provide the following church information *This question is required.

Space Cell	Name	Address	City, State	Zip
Church	Church: Name	Church: Address	Church: City, State	Church: Zip
Home	Home: Name	Home: Address	Home: City, State	Home: Zip

Financial Assistance Grant Request - CMA

Grant Criteria