Behind My Glorious Smile: Kingdom Hands Intake Form

Behind My Glorious Smile: Kingdom Hands Intake Form

💛 About BMGS Kingdom Hands: WHO WE ARE- BMGS Kingdom Hands is a faith-centered initiative committed to serving individuals and families with compassion, dignity, and purpose. OUR MISSION- Our mission is to meet people where they are — helping them rise above hardship and equipping them for long-term success while walking confidently in their God-given purpose. WHAT WE DO- We provide support, resources, and encouragement designed to strengthen lives, restore hope, and build sustainable foundations for growth. OUR PURPOSE- Our Purpose is to serve with love, lead with faith, and empower every person we encounter to move from survival to stability — and from stability to purpose.
Full Name

First NameLast Name
Phone Number

Area CodePhone Number
Email Address
example@example.com
City and State

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Household Size
Needs Assistance With
Biggest Struggle Right Now
Goals for the Next 30–60 Days (e.g., motivation, budgeting, resources, support, other)
Consent and Agreement
Optional: Would you like daily encouragement?
Preferred Contact Method
Counties we serve for local deliveries and volunteer opportunities:

Collin County/ Texas- Muscogee County / Georgia -Carroll County/ Georgia-Hillsborough County/ Florida-Craighead County/ Arkansas -Indian River County/ Florida
Should be Empty:

Counties we serve for local deliveries and volunteer opportunities: