People Helping People Ministry Assistance Request Form

Phone number

Address

Preferred Method of Contact *

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. *