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Wheels of Hope

Apply for Assistance

Please answer all the required questions below, denoted by a red asterisk (*). Incomplete applications will be delayed by efforts to verify and process the form.

Our Benevolence Committee wil review your application. Upon approval, a member of the Wheels of Hope committee wil contact you.

Processing requires at least two weeks.

Please note:
Due to our limited resources we are only able to service the greater St. Louis area.

  • Contact Information

  • (Missouri only)
  • Current Vehicle Status

  • Church Affiliations

  • If "yes":
  • Identification

  • Children

  • If "yes":
  • Personal Employment Information

  • If "yes," all fields in the section below are required:
  • Spouse's Employment Information

  • If "yes," all fields in the section below are required:
  • Joint Employment / Financial Information

  • Monthly Living Expenses

  • Please provide an approximate amount for the following monthly expenses:
  • Additional Information

  • Agreement

  • I have honestly answered all of the questions in this "Assistance Application" to the best of my knowledge and understand the "Guidelines for Benevolence Assistance." I also give permission for the appointed Wheels of Hope committee members of this ministry to verify all of the information I have supplied them. Additionally, I agree to provide a signature and a copy of my driver's license upon request to a Wheels of Hope committee member.
  • Should be Empty:

Wheels of Hope vehicle recipient

Wheels of Hope vehicle recipient

Wheels of Hope vehicle recipient

Wheels of Hope

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