Matthew 11:28 Project Bed Application
Please use the form below to apply for a bed for a child in Lawrence County (we currently are only operating in Lawrence county).

Anyone can request a bed for a child - family member, teacher, social worker, etc. Please be sure to be in contact with the family of the child if you do not live in the household. After you have filled out the application, we will be in contact with you to get more details and give you an estimate on a bed delivery timeframe!

Please note that we will only use your personal information for arranging a delivery of a bed for a child. We value your privacy and do our best to protect your identity (and your child's) through the process.
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Email *
Child's Name *
Does the child live in Lawrence county? We currently are only able to deliver beds within the county. *
Required
Family's home address (only to be used for delivery) *
Requester's name and relationship to child *
Requester's phone *
Requester's email *
Best way and time to contact you (the requester)? *
Child's Age *
Child's gender *
Other children in the home under the age of 18 and their relationship:
Type of bed being requested? *
Anything additional you would like us to know about the child or their situation prior to a discussion with one of the Matthew 11:28 Project team members?
A copy of your responses will be emailed to the address you provided.
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