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COVID-19 "ASK FOR HELP" FORM
Whether you need help or you know someone who needs help, fill out this form! We want to serve you with the love of Jesus to the best of our abilities. Someone will be in contact with you shortly.
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What is your name? (First and Last!)
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Your answer
What is your phone number?
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Your answer
What is your email?
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Your answer
You can best contact me by...
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Phone call
Text
Email
No preference
Current living situation:
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isolating at home
sick/quarantined at home
parent with a sick child
elderly at home
friends with someone sick
Not sick, just at home
Other:
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General need:
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errands/groceries
temporary work
temporary financial assistance
Spiritual guidance/someone to talk to
Other:
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Please tell us more about your needs.
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Let us know what's going on so we can best help you!
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