Care Ministry Request Form
We want to care for you with God'd love and compassion, please let us know how we can support you at this time.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
I am requesting care for:
*
myself
someone else
Recipient Name
First Name
Last Name
Recipient Email
example@example.com
Recipient Phone Number
-
Area Code
Phone Number
Recipient Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Recipient's Campus
*
Fremont
Hayward
Online
None
Recipient's Membership status:
*
Covenant member of Resonate Church
Regular attender
Don't attend Resonate Church
Recipient's Involvement:
*
In an MC
Serves on a team
None
Who is the MC leader?
Serving on which ministry team?
Who is the ministry team leader?
Please describe your situation that you are requesting care for:
*
Type of care requested at this time?
Meal train set up
Prayer
Practical help
How can we best pray?
Please just pray
Receive a phone call with prayer time
Set up a video call with prayer time
Someone to come to the home and pray
How many adults would you like a meal for?
How many kids (under age 12) would you like a meal for? If 13 or older, include them in adult count.
What types food does the family prefer? Include favorite restaurants and general cuisines.
List allergies or foods not preferred
What time should meals be dropped off?
What date would you like meals to start?
What are specific delivery instructions?
Should they text or call before dropping off, or ring door bell and leave it, etc.?
Please give us a name of close friend or family member and their contact so we can share the meal plan with them:
Please explain in detail what help is needed:
What timeframe is help needed?
Immediately, or in the next ___ weeks, or whenever, etc.
What location if different from address listed above:
i.e. picking up something at a different location, driving you to a place, etc.
Comments or questions?
Submit
Should be Empty: