Project Request Form
Splash Gordon is currently taking Project Request Applications to do minor home repair such as: repair/replace floor, weather-stripping, caulking, painting, minor plumbing repairs, build handicap ramps, minor roof repair, etc. for those in need of a helping hand. Projects will be done during Splash Gordon 2023, July 28th - 29th, as one of the ways we will be SPLASHING our community with God's love.

If you or someone you know, has a project to be considered please fill out this form completely and give as much detail as possible in describing the project.  A SPLASH representative will contact you, or the person you submitted the project for, to verify if the project has been accepted.  Due to time and logistical constraints, not all projects can be accepted.

Projects will be approved based on need, with priority given to correcting health and safety issues. Questions should be submitted to splashgordon.net@gmail.com. Deadline for project submission is June 30, 2023.
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Date *
MM
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DD
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YYYY
Requester Information
Please enter the following information for the person making the request
Requested by *
Enter the name of the person requesting the project
Home Phone *
Cell Phone *
E-mail *
Church/Organization *
Enter the name of your church or organization you are affiliated with
Church/Organization Phone *
Recipient Information
Please enter the following information for the person or organization the project is being requested for:
Recipient's Name *
Enter the name of the person in need or a contact person for the organization
Organization's Name
Enter the name of the organization that will benefit from this project
Physical Address *
Enter the address of the project location
City *
Zip Code *
Recipient's Phone *
Enter the primary phone number for the recipient/contact person
Alternate Phone *
Enter an alternate phone number to reach the recipient/contact person (could be family member, neighbor, etc. if needed)
Best time to contact? *
Enter the best time of day to call or visit the recipient/contact person
Is this a rental property? *
Landlord's Name
If applicable
Landlord's Phone
If applicable
Project Information
Please describe the project in as much detail as possible.  What exactly needs to be done?
Project Description *
Benefit/effect of project: *
Materials needed: *
Can project be completed in 2 days? *
Would photography and/or video be allowed at this project site? *
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