Community Unity Form

1

Name

First Name

Last Name

2

Email

example@example.com

3

Phone Number

Please enter a valid phone number.

4

This Need is . .

For me

A neighbor or someone I know

5

The Nature of this Need is . .Check all that apply

Physical Labor or household project

Temporary financial need

Spiritual / emotional need ( someone to visit or call )

Other

6

Please type a brief description of the need Any details that would be helpful

7

If this is a Household Project ...Check all that apply

The property is owned by myself or the would be recipient of help

The property is a rental or owned by someone else

Can’t afford the expense of the project

Physically unable to do the project myself

Other

8

I understand that the community unity project is an outreach ministry comprised of volunteers from within the community to aid and assist our neighbors and friends. By submitting this form, I agree to act in good faith, and in a spirit which fosters harmony.