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People Helping People Ministry Assistance Request Form
Your name
*
Last name
Email address
*
Phone number
Phone type
Mobile
Home
Work
Other
Address
Home
Work
Other
Country
Country
Street address
Apt/unit/box (optional)
City
State
Postal code
Preferred Method of Contact
*
Select…
Phone Call
Text
Email
Who lives in the home?
*
Please check all that apply.
Single Parent
Widow/Widower
Elderly Individual
Disabled Individual
Family with children
Other
Do you attend our church?
*
Yes
No
What type of project is it?
*
Please check all that apply.
Hanging Pictures/TV
Small Home Repair
Plumbing Repair
Electrical Work
Yard Cleanup/Cutting Shrubs
Furniture Assembly
Painting
Wheelchair Ramp Assistance
House Cleaning/Organizing
Minor Car Repairs
Other
How urgent is this need?
*
Emergency
Within 1-2 weeks
Flexible Timing
Has anyone already looked at this issue?
Yes
No
Are there any pets in the house?
*
Yes
No
Are there any health or mobility concerns our team should know about?
*
Is someone 18 years or older available during the visit?
*
Yes
No
Do you already have the materials needed for the project?
*
Yes
No
Partial
What days are you available?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Preferred Time
*
Morning
Afternoon
Evening
Ministry Acknowledgement
Please understand that our People Helping People Ministry consists of volunteers who offer basic assistance and may not be licensed professionals. Projects will be evaluated based on volunteer availability, safety and scope of work.
By checking you agree to the above statement.
*
Please write in your full name. You also understand that this will be considered a signature.
*
Submit
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