God's Garage Car Application - Washington Heights Church

God's Garage Disclaimer

Please answer the questions to the best of your ability. The more information you provide the better God's Garage will be able to assess applications. This ministry is run by volunteers with a heart to serve Jesus by providing help to those in need. As a result of the number of applicants and donations, this process takes time. Please be patient as you wait. by filling out this application, your acknowledge the following:
1. You are not filling out this application for someone else.
2. That you are a single mother, a widow or the wife of a deployed military member.
3. You have a valid driver's license in good standing.
4. There is no other vehicle currently titled in your name.
5. Approximately 10% of the women that apply with God's Garage receive our assistance.
6. If you qualify and are chosen to receive a vehicle from God's Garage you will be required to transfer the car into YOUR name and obtain insurance on that vehicle.
7. God's Garage does not tolerate inconsiderate, harassing or hostile behavior towards any volunteer, including use of profanity, or other abusive actions and language.
8. All the information you are providing to the God's Garage team is confidential unless you have given permission to disclose it.

I have read and understand the God's Garage Disclaimer. *

Date *

Address

Phone number *

Driver's License Number *

State Driver's License was Issued *

Driver's License Expiration Date *

If your current name and address does not match your driver's license, please list the name and address on your driver's license for office use. *

Birthday *

Current Status *

Single

Married

Divorced

Separated

Are you a military wife? *

Yes

No

Gender *

Do you currently own a vehicle? *

Yes

No

Please list all members of your household including age and relationship. *

What is your present mode of transportation? *

Friends

Spouse

Family

Bus

Other

How do you feel you arrived at this point in your life? OR What events caused you to be in this situation? *

Are you currently employed? *

Yes

No

Place of employment

Job Reference *

Please provide an Employment Reference

Are you actively looking for a job? *

If currently employed, select "other"

Yes

No

Other

Have you been helped by God's Garage before? *

Yes

No

Have you applied for any other assistance at a church or other organization?

Yes

No

Are you able to afford the following items if you were to receive a vehicle? *

Check all that apply

Auto Insurance

Gasoline

Car Maintenance

How many people does the car need to carry? *

(In addition to yourself)

Can you drive a manual transmission? *

Choose one

Yes

No

Door Preference *

Choose one

4 Door

2 Door

Either

What is your church or religious affiliation, if any? *

Would you be willing to attend a Sunday morning service at Washington Heights Church? *

Yes

No

Are you wiling to be interviewed on camera? *

Choose one

Yes

No

If no, would you mind explaining why?

Is there anything else you would like to tell us? *

References

Reference #1 Full Name *

Reference #1 Phone Number *

Reference #1 Email Address *

Reference #1 Relationship *

Reference #2 Full Name *

Reference #2 Phone Number *

Reference #2 Email Address *

Reference #2 Relationship *

Reference #3 Full Name *

Reference #3 Phone Number *

Reference #3 Email Address *

Reference #3 Relationship *

Terms and Conditions

God's Garage will assess applications in the order received. Should your contact information change, please let us know. By digitally signing below you agree to the process and understand that if we cannot contact you, your application will be inactivated.

I have read and accept the terms and conditions. *

Digital Signature *

Address