Godsend Garage Assistance Request
  • This form is to request automotive services from Godsend Garage, a ministry of Crossroads Community Church.
  • We are only able to service guests in the Kokomo vicinity.
  • Only 1 vehicle is allowed per application.
Email *
What is your full name? *
What is your address, including city and zip code? *
What is your phone number, including the area code? *
Are you a widow or single mother? *
What are the names and ages of the people in your household, including yourself? *
What is the year, make, and model of your vehicle?
(example: 2013 Ford Explorer)
*
Describe the problem with your vehicle. *
What happened to you that put you in a position to request help?
*
Please list the sources and amounts of your household income. *
How did you hear about Godsend Garage? *
How else can we pray for you? *
If accepted, I will be put on a waiting list.
*
Required
If accepted, it is my responsibility to pay for any and all parts used in the repair. (Labor is free).
*
Required
Due to the volume of applications and garage capacity, the following conditions apply: 
 - I am not guaranteed to receive service.
 - I release Godsend Garage from any liability.
 - I understand my application will remain on file for 1 year.
*
Required
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This form was created inside of Crossroads Community Church.

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