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Assistance Request Form

IMPORTANT: LOCATION CHANGE FOR 2025! 

Meeting will be held at Creston Canaan United Methodist Church located at 166, S Main Street; Creston, OH 44217 on November 16, 2025.

Creston Community Service Club (CCSC)

 

 

Request for Financial Assistance - 2025

 

Submission Deadline: Monday, November 10, 2025
Presentation Meeting: Sunday, November 16, 2025
Meeting Location: Creston Canaan United Methodist Church, 166 S Main Street, Creston, OH 44217
 

 

I. Organization Information

Name of Organization _______________________________________________________
Mailing Address _______________________________________________________
Contact Person _______________________________________________________
Phone Number _______________________
Email Address _____________________________
Individuals Served Number of Individuals in the program: ________
 

Organization Type (Please check all that apply)

Type Check Type Check
School Program ( ) Community Program ( )
Private Organization ( ) New Program ( )
Existing Program ( )    
 

II. Financial and Fundraising Details

   
Organization's Yearly Income $________________________________
Organization's Yearly Expenses $________________________________
Primary Source(s) of Funding _______________________________________________________
 

 

Fundraising Efforts

 

List the fund raisers your organization has conducted or plans to conduct in the current year:

 

III. Request Details

Purpose of Funds

Your request for funds from the CCSC will be used for the specific purpose of: (Be as specific as possible about what the funds will purchase or support.)

 

Creston Ox Roast Involvement

Does your organization assist with the Creston Ox Roast? If yes, please explain the capacity in which your organization helps:

 

Additional Comments

Use this space for any information you wish the CCSC to consider:

 

IV. Submission & Signature

 

 

Submission Instructions

 

Please return the completed form by November 10, 2025, via one of the following methods:

  1. Mail: CCSC c/o H. Uhler 202 S Crestview Dr. Creston, OH 44217

  2. Email: B. Haynes at beth.j.haynes@gmail.com

Signature Date
Signature: ________________________________ Date: ____________________________