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.

Your application will be given to one of the churches that we partner with.
You will only be contacted if your name has been selected as a potential candidate for a vehicle.

Your application will be kept on file for 2 years. If at the end of 2 years you are still in need of a vehicle then you will need to apply again.

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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