Request for Financial Information

This standard form is required of all Applicants. Please answer all inquiries that pertain to you as the Applicant and, if pertinent, to the “Householder(s).” You may add additional explanatory information on a separate page. All information is treated as confidential by the Society. If you need assistance in filling out the Financial Form, please contact Rev. Mark W. Harris, (207) 347-9741 or

Other or additional sources of support are often available through your denomination If UUA, please contact the Director of Church Staff Finances, UUA and/or the Secretary of the Society for Ministerial Relief, UUA. If UCC, please contact the Director of Grants and Scholarships, Pension Boards, UCC.

(if different then home address)