THIS SURVEY WILL ONLY BE LIVE FOR 24 HOURS - WE HAVE A SMALL WINDOW TO APPLY FOR COVID-19 FINANCIAL RELIEFThis survey is an attempt to gather information from houses of worship and not for profits to best position us to apply for a share of $349 billion allocated through the CARES Act. To do this, we need to know who your house of worship banks with and if your bank is a CARES Act lender. With this information we can better position ourselves with banks to get our applications processed and prayerfully approved. We are asking you to please complete this quick survey, which should take no longer than 2-3 minutes. Name *FirstLastEmail *EmailConfirm Email1. Has your church experienced financial hardship, or anticipates experiencing financial hardship because of the COVID-19 Social Distancing Mandate? *Select from the Drop Down YesNoHouse of Worship Name: *Are You the Senior/Highest ranking Leader in the Local House of Worship? *Select from the Drop DownYes! Same as AboveNoSenior/Highest Ranking Leader NameFirstLastSenior/Highest Ranking Leader eMailEmailConfirm EmailHouse of Worship Address: *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeChurch Phone Number: *2. We want to demonstrate our collective numbers and strength, please enter the number of members on your house of worship membership role + regular visitors + the number of people your congregation reaches in the community. (Your individual information will not be made public, but we will make public in an anonymous format our collective numbers) *3. We have to start organizing and demonstrating our collective economic power, please list each financial institution that your house of worship does business with (i.e., Chase, Bank of America, Wells Fargo, TD Bank, etc.). Check ALL That Apply. *Chase BankCarver BankBank of AmericaWells FargoU.S. BankKey BankTD BankM&T BankCitibankCapital One BankHSBC BankNew York Community BankCitizens BankPeople's United BankNBT BankTrustCo BankSterling National BankApple BankSantander BankFive Star BankOtherOther Bank Institution(s):Is the institution that you bank with processing Paycheck Protection Program applications? *Select from the Drop DownYes NoDon't Know4. As we continue to advocate and lobby for houses of worship, please help us identify your house of worships TOP 3-5 areas of greatest financial need (check all that apply): *Food PantryAfter School ProgramAdditional StaffingFeeding ProgramsYouth MinistryYoung Adult MinistryUtility ExpensesBuidling MaintenancePaper ProductsMarketing and Promotional MaterialsWebsite DevelopmentSocial Media MarketingStreaming ServicesPrinting CostsInsuranceRetirement PlanCapital ImprovementsOtherOther Financial Needs: (Please List)Please provide a contact name and contact information for someone other than the Senior Leader of the House of Worship who can serve as a point of contact. Church Contact Person: *FirstLastChurch Contact Person Email:EmailConfirm EmailChurch Contact Person Mobile Phone:NameSubmit
