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  • McConnell does not provide cash to anyone. If assistance is provided, a check will be mailed directly to the creditor. Please understand that our funds are limited and we cannot pay large bills for anyone.
  • Please enter a number from 18 to 99.
  • ElectricityWaterPropane
    If no, anticipated cut off date is put in "other"
  • MM slash DD slash YYYY
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  • MM slash DD slash YYYY
  • Name of ChurchAssistance Provided 
  • Drop files here or
    Accepted file types: jpg, gif, png, pdf, tiff, doc, docx, Max. file size: 50 MB, Max. files: 2.
      If you do not have this currently, please bring these items to the church office.
    • Reset signature Signature locked. Reset to sign again
      I understand the information provided on this form may be shared/verified with the Department of Family & Children Services, Ninth District Opportunity, and other agencies/creditors. I authorize the Department of Family & Children Services, Ninth District Opportunity, and other agencies/ creditors to release information concerning my case and/or my billing/account status.
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