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Please note that a change to our process for assistance requests has changed. Please complete the form in order to submit an application for assistance.
First Name
First Name is required.
Last Name
Last Name is required.
Email
Email address is not valid
Email is required.
What is the best phone number that we can reach you at (all requests must be processed over the phone)?
What is the best phone number that we can reach you at (all requests must be processed over the phone)? is required.
What is your date of birth?
What is your date of birth? is required.
Do you attend Echo.Church?
Yes
No
Other
Do you attend Echo.Church? is required.
Which Echo.Church campus do you attend, if any? If you do not attend a campus, which campus is closest to you?
North San Jose
Sunnyvale
Fremont
Which Echo.Church campus do you attend, if any? If you do not attend a campus, which campus is closest to you? is required.
What is your home address?
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
How did you hear about Echo Compassion? If referred by someone, please specify their name. If online, please indicate which site (i.e., Facebook, NextDoor app, etc.) and type of content (i.e., post, comment, etc.)
How did you hear about Echo Compassion? If referred by someone, please specify their name. If online, please indicate which site (i.e., Facebook, NextDoor app, etc.) and type of content (i.e., post, comment, etc.) is required.
Please provide a brief explanation of why you are requesting assistance. (Type of assistance, reason for need of assistance, any specifics regarding your request, etc.)
Please provide a brief explanation of why you are requesting assistance. (Type of assistance, reason for need of assistance, any specifics regarding your request, etc.) is required.
Have you received assistance from Echo.Church or Echo Compassion previously?
No
Yes
Have you received assistance from Echo.Church or Echo Compassion previously? is required.
What other ways or resources have you used to help your situation (other than Echo.Church | Echo Compassion)?
What other ways or resources have you used to help your situation (other than Echo.Church | Echo Compassion)? is required.
What is your plan for recovery if your request for assistance is approved? What can you do in order to avoid having to request additional help in the future? (Please be as detailed as possible in your response)
What is your plan for recovery if your request for assistance is approved? What can you do in order to avoid having to request additional help in the future? (Please be as detailed as possible in your response) is required.
Which of the following ways are you open to considering to assist you with recovery? (Mark all that apply)
Attending a Financial Peace University class or receiving financial tools/education
Counseling
Temporary Housing through a local shelter
Food bank or Soup Kitchen
Joining an Echo Group
Attending Sunday service or Bible Study
Serving on a team
None of the Above
Other
Which of the following ways are you open to considering to assist you with recovery? (Mark all that apply) is required.
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