Financial Assistance Application



Any Cherokee County resident may apply for financial assistance through the Good Samaritan Fund at Hillside UMC by submitting this application. The purpose of this application is to get to know you and your circumstances, so please answer as honestly and completely as possible. We are not here to pass judgment, only to obtain the most complete information with which to serve you in the best way possible .

Applications will be reviewed on Thursdays at 1:00pm  weekly or every other week. Only completed applications will be reviewed. Completion of the application and/or communication with church staff or volunteers does not guarantee that assistance will be provided. Any assistance will be sent directly to the service provider and will take at least a week to receive if approved. If you are approved to receive financial assistance, you will hear from us by 3:00pm on the Thursday that applications are reviewed.
Assistance may be provided to an individual or family a maximum of one time per 6 months.

We are unable to provide financial assistance for hotel stays. We can provide assistance with utilities (gas/electric/water), and with rent/lease/mortgage payments within our monetary constraints. Motels, hotels and extended stay facilities do not qualify.

Information from this application will be seen and shared on a confidential basis only with Hillside staff and volunteers who are part of the Benevolence Team; and, with related agencies as explained further in this application. .

If you are unable to fill this application out online, a printed version is available. You may come by and pick one up or we will be happy to mail it to you. Please call our main office at (770) 924-4777 for more information.

Additional Resources:
Cherokee County Community Resources Directory
Cherokee County Homeless Coalition
Forever Fed
MUST Ministries
Recovery Organization of Cherokee County
United Way of Greater Atlanta

The ACTS Cherokee Assistance Network, hereinafter referred to as "CharityTracker", is a shared, computerized record keeping system that captures information about people experiencing need for emergency services, including but not limited to assistance with utility bills, medications, rent/mortgage payments, etc. Papa's Pantry (Administrating Agency) administers CharityTracker on behalf of participating agencies of the CharityTracker Assistance Network, including Hillside United Methodist Church (Participating Agency). I understand that all information gathered about me is personal and private and that I do not have to participate in CharityTracker. I have had an opportunity to ask questions about CharityTracker and to review the basic identifying information, which is authorized by this release for the CharityTracker Assistance Network Participating Agencies to share. I also understand that information about non¬confidential services provided to me by CharityTracker participating agencies may be shared with other CharityTracker Participating Agencies. This Release of Information will remain in effect for 3 years from the date noted under my signature at the bottom of this page unless I make a formal request to this Organization that I no longer wish to participate in CharityTracker. I authorize Hillside United Methodist Church, as a CharityTracker Participating Agency, to share my basic, identifying and non¬confidential service transactions/information with other CharityTracker Participating Agencies. I authorize the use of a copy of this original to serve as an original for the purposes stated above. Ifurther authorize Hillside United Methodist Church (Participating Agency), as a CharityTracker Participating Agency, to share my dependent's basic, identifying and non¬confidential service transactions/information with other CharityTracker participating agencies.