Join Hands Ministry Application for Furniture/Appliance

Please note, This program is completlely different for 2024. Join Hands no longer has free delivery by volunteer men and we no longer have furniture storage at our facility. We no longer will be accepting donations of furntiure either nor we will have any furniture/appliances at our facility.

Join Hands will be working with two donors in the community to try and meet the furniture/appliance need. These two individuals WILL NOT be able to deliver the furniture/appliance needed. If you are contacted by one or both of these donors, it will be your responsible to make arrangements to pick up the item.

Please fully fill out this application according to your need. After submitting the form, our team will review your application and forward your information (name, phone number and item needed) to the donor. IF THE DONOR HAS THE ITEM REQUESTED THEY WILL CONTACT YOU. DO NOT CALL Join Hands if you haven't been contacted, once we accept your application and forward the information onto the donor we are no longer involved in this process and will not be caling the donor to follow up as to why they haven't called you.

The Donors have items coming and going to the timeframe in which you wait is not set.

All information shared on this form will remain confidential within Join Hands Ministry. Your information WILL BE shared with the Donor.

Name*

First NameLast Name

Birthdate*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number (best number to reach you)*

Are you in need of furniture (i.e. - bed, chair, table, couch) or appliance (i.e. refrigerator, stove, washer, dryer)*

FurnitureApplianceOther

What piece(s) of furniture are you in need of today? If you are in need of a bed, please indicate the size (bunk, twin, full, queen, or king).*

Note: All requests for furniture are subject to availability and a waitlist. Join Hands Ministry relies on donations and cannot guarantee the availability of any piece of furniture.

What appliance(s) are you in need of today? Please be sure to indicate if you are in need of gas or electric appliances.*

Note: All requests for appliances are subject to availability and a waitlist. Join Hands Ministry relies on donations and cannot guarantee the availability of any appliance.

Do you currently own or rent your home?*

OwnRentOther

Landlord Name & Phone Number*

Note: Join Hands Ministry will contact your landlord to confirm that the appliance being requested/received is permitted and appropriate hookups are onsite.

What is preventing you from being able to purchase the item requested? *

Have you or anyone in your household been helped by Join Hands Ministry in the past?*

YesNoNot Sure

Please describe the assistance you received and the approximate date.*

How long have you lived at your current address? *

Do you own or have access to a car?*

Yes, I own a carYes, I have access to a carNoOther

How do you anticipate picking up the appliance/furniture?

Have you contacted anyone else regarding your current need? (Please select all that apply)*

Has anyone else offered to help with your request? If yes, please list how they are helping you. If no, please type "N/A".*

Have you contacted anyone else for assistance in the past 6 months? If yes, please briefly describe the situation and how you were helped. If no, please type "NO". *

Are you receiving any aid or funding from a government program/agency?*

YesNoI'm not sure

Disclaimer, Client Consent, & Signature:

I hereby authorize the release of information to Join Hands Ministry to receive assistance I am requesting. I further certify the information I have provided is true and correct and that if requested, all income and expenses have been reported. I understand that Join Hands Ministry may verify the information on the application and any deliberate misrepresentation of information will be subject to denial of assistance and services. I authorize Join Hands Ministry to discuss my case with other agencies (list of partnering agencies), businesses, churches, attorneys, individuals or others deemed necessary to verify the accuracy of information and/or identify additional sources of assistance. I understand that all information will remain as confidential as possible within these entities. I have read, understand and agree to the policies above regarding the Release of Information.

By typing your full name in the box below, you are providing your signature and acknowledging that you have read and understand the above statement. *

Type full name here.

Driver's License/ID*

Proof of Residency

Application for Furniture & Appliance

NOTE: