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Complete/Print or Print/Complete the 5 Page Application. After you have spoken with one of our coaches or counselors, please complete and print the 5 page application. NOTE: If you are married, both spouses must complete page one separately down to and including the Personality Style Inventory. Then please mail your completed package TO INCLUDE COPIES OF YOUR INCOME TAX RETURNS FOR THE LAST TWO YEARS, A RECENT PAY STUB and COPIES OF YOUR MOST RECENT CREDITOR STATEMENTS to
Christian Financial Ministries
850-B Old Piedmont Road
Marietta, GA 30060
We will be back in touch with you the day we receive your application package.
- COUNSELING APPLICATION SURVEY FORM
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Please select the ONE set of circumstances that BEST describes
your present situation: |
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Personal assets liquidated; possible
jail time; credit record impacted for 10 years; sleepless nights; depression;
withdrawal from family and friends. |
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Threatening phone calls and letters from creditors; lots of arguments
over money; credit cards "maxed" out; begin working two or three
jobs. |
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Expenses exceed income; only able to make minimum
payments; handle emergencies with credit cards; no savings; peer pressure. |
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Income = Expenses; "surprises" consistently prevent any attempts
to save; lots of worry, anxiety, and fear about the future. |
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Income greater than expenses; bills consistently paid
on time; regular savings; 3-6 month emergency fund has been established. |
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No worries about debt, investments, or material things. Consistently
using surplus funds for meeting needs of God's people; inner joy in abundance. |
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- Briefly describe your current spiritual journey.
Include any short-term and long-term spiritual goals. Do you know without doubt that if you die today you will go to heaven?
- Briefly describe your current financial situation.
Include any short-term or long-term financial goals.
- How
did you hear about us?
- Personality Style Inventory
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7. Just For Those With Home Mortgages
- Are you delinquent on your mortgage payment? Yes__ No__
- If "yes," how many months? ___
- Have you received notice that you home is in foreclosure? Yes __ No __
- When did you buy your home? _______________
- Have you refinanced since you first bought your home? Yes __ No__
- If "yes," how long ago? _______
8. Ethnicity (to help us comply with Federal Reporting Requirements)
- Hispanic ____
- Not Hispanic ____
- Chose not to respond ____
9. Race (to help us comply with Federal Reporting Requirements)
- American Indian/Alaskan Native ____
- Asian ____
- Black or African American ____
- Native Hawaiian or Other Pacific Islander ____
- White ____
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After Printing, Click Here For Form 2 |
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