Mercy Angel Form
Application for Assistance on Behalf of Another in Need
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Name of Angel:
Phone Number of Angel
Name of Person in Need of Assistance:
Phone Number of Person in Need of Assistance:
Please provide a brief description of the situation of the person you are requesting assistance for:
Please provide a brief description of the assistance you beleive this person would benefit from (include details such as dollar amount, duration of assistance, or if specific items are needed like diapers, handmade masks, grocery delivery service, etc.)
Are you able to affirm that the reason this person needs assistance is related to COVID-19? (Answer does not impact the approval/non-approval of assistance).
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