WELS Christian Aid and Relief General Grant Request Form

Church Information
A field marked with a red asterisk is required.
Select ministry field*
- Home mission
- Parish
- World mission
Mission district*
District*
Mission team*
World mission country*
Other country*
Type of request*
- Disaster grant
- Personal Financial Grant - Required for Congregational Employees
Church name*
Church address*
Street address City State/Province/Region ZIP / Postal Code Country
Pastor name*
E-mail*
Phone
Information for Whom Aid is Requested
Name*
• This IRS requested information will remain confidential.
• Personal Financial Grant - Required for Congregational Employees
First Last
Is the grant recipient a veteran or active duty military?*
- Yes
- No
Is the address above the same as the personal address for this request?*
- Yes
- No
Address*
• For Address, enter the full address including street, city, state, zip and country.

Street Address Address Line 2 City State / Province ZIP / Postal Code Country
Is there a PO or Apt# in your address?*
- Yes
- No
Enter your apartment number or PO box number:*
This field is hidden when viewing the form
Name(s)*
• This IRS requested information will remain confidential.
• For Address, enter the full address including street, city, state, zip and country.
• Select (+) icon to add a new row.
First Last Address
This field is hidden when viewing the form
Recipient for disaster relief
• This IRS requested information will remain confidential.
• For Address, enter the full address including street, city, state, zip and country.
• Select (+) icon to add a new row.
Congregation Address

Contact Information
Date*
MM slash DD slash YYYY
Request submitted by*
First name Last name
E-mail*
A confirmation e-mail will be sent to the e-mail provided.
Enter e-mail Confirm e-mail
Phone*
Data Privacy & Permission*
I AGREE with the terms of the WELS Privacy Policy.
NOTE TO EU CITIZENS, RESIDENTS, TOURISTS, AND OTHER PERSONS TEMPORARILY IN THE EU:

By submitting this form you consent to any and all information you provide and submit via the site being sent to the United States of America. The United States has not sought nor received a finding of “adequacy” from the European Union under Article 45 of the GDPR. WELS relies on derogations for specific situations as set forth in Article 49 of the GDPR. You are also informed that the United States presently does not have an adequate level of personal data protection as determined by the European Commission’s adequacy decision on October 6, 2015 (case c-362/14) and articulated in the European Union’s General Data Protection Regulation and has not received a similar designation of adequacy by any other foreign data protection authority. You agree to the transfer of your data and personal data to the United States, however, to be used in accordance with WELS Privacy Policy.

First	Last	Address

Congregation	Address