Name: Gold Rush Father/Son Campout
Start: 2019-07-12T12:00:00-06:00
End: 2019-07-14T13:00:00-06:00
Location: Winding River Resort

Employment Income*

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Employee	Employer	Monthly Income after Taxes

Other Adults in Household (age 18 and older)

Name	Age	Relationship to you	Working? Yes or No	Income

Minors in Household (age 17 and younger)

Name	Age	Relationship to you	Working? Yes or No	Income

Monthly Vehicle Payments

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Year	Make	Model	Monthly Payment Amount

Monthly Credit Card Expenses

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Balance due	Monthly Payment

Monthly Education Debt Expense

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Total Due	Monthly Payment

Other Monthly Credit Expense

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Balance	Monthly Payment

How long have you attended Grace Chapel?*
How often do you attend?*
- Never
- Occasionally
- Monthly
- Two or three times a month
- Every Week
- More than once a week
List specific activities and groups at Grace Chapel in which you are involved:*
What is at stake?*
Have you asked your family for support?*
If so, what was the outcome? If not, why not?
How do you see God working in this situation?*
How has this situation affected your relationship with God?*
What steps have you taken to prevent reoccurrence of this situation?*
Would you be willing to discuss and commit to strategies for preventing a reoccurrence?*
- Yes
- No
Are there additional or special circumstances that would help us in reviewing your request?*

Financial Assistance

Financial Information