Floor-to-Bed
Request Form
About
Our Floor-to-bed program began in 2018 with the initiative of providing children with a place to receive a safe, sound, and comfortable space to sleep. Since then, City Lights Ministry has built and delivered over 1000 beds to children of all ages. We offer Single (Twin) and Bunk Bed style frames, mattress(es), sheets, pillows, etc. at not cost to you.
Instructions:
Please complete each section below and click submit. (IMPORTANT: Each bed is scheduled and delivered on a first come, first serve, basis. Our primary form of communication for scheduling and delivery will be by e-mail)
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
How many children need a bed?
*
Please provide the name, age, favorite color, and one hobby/interest of each child
*
Example: Toby- 12-Blue-Basketball or Daisy-8 -Pink-Barbie
Single (Twin)
*
Please Select
0
1
2
3
4
5
6
Example: 1 Child per Twin
Bunk Bed
*
Please Select
0
1
2
3
4
5
6
Example: 2 Children per Bunk Bed
Which children will share a Bunk Bed?
Example: Daisy and Kya
Which child(ren) will receive a Single (Twin)?
Example: Toby and Bailey
Comments, questions, or concerns?
Submit
Should be Empty: