Kirk Assist Request Form

Kirk Assist provides targeted, limited, and temporary assistance to Kirk of the Hills members,
their families, and those with connections to our church or our local mission partners. We exist
to help recipients get back on their feet by meeting a short-term need.

Please read this carefully as applications that fall outside the scope of our ability to help
cannot be considered.

Your name *

Email address *

Please list your middle name: *

Phone number *

Address *

Pease provide the full name of the person and/or organization that referred you to us, and your connection to them.. *

Kirk Assist exists to help with targeted, limited and temporary assistance to those with connections to our church, our members and their families, and our local mission partners. Submissions referred through other avenues will not be considered.

Please provide specific information about the circumstances that led to your need, the type of need you have, the dollar amount, the due date, etc. *

Please be specific and provide as many details as possible.

Financial *

Please provide circumstances that led to this request (illness, accident, divorce, laid off, etc), specific need (rent, utilities, etc.), and amount.

How can we pray for you?

Thank you for your request. A Kirk Assist team member will be in touch soon. Please allow up to one week to receive a response.

“May the God of hope fill you with all joy and peace as you trust in him, so that you may overflow with hope by the power of the Holy Spirit.” (Rom 15:13)

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