Request for Pastoral Assistance
from Wesley United Methodist Church
Email *
Name *
Email *
What do you need assistance for, specifically, and for what amount? *
What is today's date? *
Full mailing address *
Phone number *
Have you applied for other assistance? *
What agencies have you applied to and when? *
What is your source of income? *
How much income do you receive each month? *
How many adults live with you? *
How many children live with you? *
A copy of your responses will be emailed to the address you provided.
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