JCS Help Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

JCS Help Form

Jewish Collaborative Services is honored to serve the community during this time of crisis. As stated in Deuteronomy, “A community is too heavy for anyone to carry alone.” We will continue to do our best to meet the needs of our community during this unprecedented time. Together and with your help, we will work together and continue to “be here” to serve all those who are in need.

If anyone in the community is in need, please have them complete this form or simply call us at (401) 331-1244 with the information. If you are referring someone in need, please make sure that person is aware that you are sharing their name and contact information.

As always, call 911 for any emergency.

First and Last Name *

Home Address

Best Phone Number to Call *

Email Address

Synagogue Affiliation, if any

What do you need (Check all that apply) *

Donated food or basic household supplies delivered to my home

Someone to pick up and deliver prescriptions, groceries or supplies to my home

Kosher boxed lunch delivered to my home (Only if 60 years or older & within 10 mile radius of providence)

Help navigating COVID-19 related financial assistance

Help navigating social services

Someone to talk to by phone or to check-in

Other:

Required

If you are referring someone, what is your relationship with the person you are referring to? List your NAME, RELATIONSHIP, and YOUR CONTACT info below *

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms