MECCA's Community Closet Registration
PROVIDING SUPPORT TO MORNINGSIDE, EAST ENGLISH VILLAGE, & CORNERSTONE VILLAGE RESIDENTS IN NEED. By registering to receive donations from MECCA's Community Closet you agree to hold harmless MECCA Development Corporation and the donating Corporations from any liability resulting from the donations received.
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How did you hear about MECCA's Community Closet? *
First Name *
Last Name *
Home Address *
Proof of Address is required in the form of a utility bill. (Recipients must live in MorningSide, East English Village, or Cornerstone Village neighborhood except for emergency circumstances-illness or fire.)
Email Address *
Phone Number *
How many people are in the household? (Report card or driver's license is required for all occupants.) *
Required
Age of people in the household. (Please provide the age of everyone in the house.)
Person 1
2
3
4
5
6
7
Age 0-5
6 - 9
10 - 13
14 - 17
18 - 25
26 and older
What is your family's greatest need? *
What causes your need? *
To be completed by a MECCA Development Corporation representative
To be completed by a MECCA Development Corporation representative - Please indicate the large items obtained.
Small Appliance
Comforter
Vacuum Cleaner
Coat
Baby Item
Other
Mar 2021
Apr 2021
May 2021
Jun 2021
Jul 2021
Aug 2021
Sep 2021
Oct 2021
Nov 2021
Dec 2021
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