Caring Deliveries
During this COVID-19 pandemic and the need to physically isolate to prevent further spread of the virus, many may not be able to leave their homes to get the supplies they need.  This may be due to the inability to use transit, or drive a car, or need to quarantine.  If you need assistance arranging delivery of groceries, supplies, and/or medications, please contact us and we will arrange for someone (a volunteer) to coordinate deliveries/assistance.  

*Please note this service does not include volunteers purchasing groceries, supplies, or medication.
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Gender
Clear selection
What are your needs?  (for example, help ordering groceries, getting groceries delivered) *
What do you need delivered? *
Required
If other, please list:
Phone Number: *
Email Address:
What is the best time for drop off?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Fraser Lands Church. Report Abuse