The Refuge Closet Clothing Request
We are located at Fairview Baptist Church, 127 Airline Road, Columbus, MS 39702.
Your Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Who is Requesting Clothes?
*
I am requesting clothes for myself
I am a parent requesting clothes for my child
I am a case worker requesting clothes for a client
Other
How did you hear about us? (Social worker, School counselor, other)
School
Age
Gender
Female
Male
Shoe Size
Shoe Size Category
Toddler
Youth
Adult
Shirt size
Shirt Size Category
Child
Adult
Pant size
Pant Size Category
Child
Adult
At a school with uniforms? (if so, what colors?)
Race (to match hair products with hair type)
Need diapers, pull-ups, or underwear?
What size (diapers, pull-ups, or underwear?)
Bra needed? Please include size below.
Other needs? (Do you need clothing for work, church, general or school?) Any (Specifics we need to know?)
Prayer Requests?
Submit
Should be Empty: