Congregational Connection Care Request

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Let us know if you need some help, if you can help, or if you know someone who needs help.

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Your Name: *

Phone number (no dashes) *

email contact: *

Address

Reason for request *

I need some help

I would like to provide some help

I know someone who needs help

Obligatorisk

Name of person who needs help (if not you)

Help Requested (Within social distancing guidelines, as available)

Grocery Delivery

Pharmacy Pickup

Periodic check-in/connection

Call from the Pastor

Receive card in mail/ Send card to someone

Meals

Ride

Emergency Childcare

Övrigt:

Additional details of what is needed

Skicka

Rensa formuläret

Skicka aldrig lösenord med Google Formulär

Formuläret skapades på Glenelg United Methodist Church. Anmäl otillåten användning