Request Form For General Assistance From Asa's Angels (NOT HOLIDAY ASSISTANCE)
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Please read this page in its entirety prior to moving forward with your request form for General Assistance from Asa’s Angels.

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Asa’s Angels is Accepting Registrations from Families for General Assistance throughout the Calendar Year. If you are applying on this General Assistance Form; Please know that this form is NOT FOR HOLIDAY ASSISTANCE (ie- Christmas, Easter, School Supplies Drive, etc). If you are looking for Holiday Assistance: Please Apply on the Correct Registration (as dates allow) as listed on our website. This General Assistance Form is for Hardship Situations and Needs Such as: Beds, Bedding, Furniture, Dishes, Food, Toiletries, etc. Please note that Asa’s Angels is limited to provide cash assistance towards Rent or Bills. *
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Please note that Asa's Angels is unable to Deliver, and that you will need to Arrange for Pick Up, Is this Possible? If Yes, Please Proceed Forward with Your Application! *
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PICKUP TERMS: Please Advise During the Pickup of Your Item, the Terms are as Follows:  1. You MUST Bring Assistance with you to HELP Load Your Item -- 2. You MUST Bring a Proper Vehicle to be Able to Transport Your Item  -- 3. You MUST Bring Your Own Straps to Secure Your Item for Safe Transporting. *
Pertaining to Your Used Item HOLD HARMLESS AGREEMENT: Your acceptance below acknowledges and specially agrees that you, along with any party who may claim under or through you; that you are hereby knowingly and voluntarily releasing and holding harmless: Century 21 Asa Cox Homes, Asa’s Angels, It’s Affiliates and All parties involved with the donation of your used donated item. You hereby are voluntarily agreeing, that you will hold all parties harmless from any and all claims, counterclaims, demands, damages, actions and any causes of action; of any known or unforeseen issues or concerns regarding your used item. The Acceptor of the Used Item, the Non-Profit and it's Affiliates, agree that they will not have any now or future obligations to each other after the used item is picked up, and for the purpose of this agreement it shall become legally binding once the used item acceptor has clicked "Agree" below. *
Asa’s Angels cannot guarantee that with your submitted registration for general assistance we will be able to help. Depending on Community Support & Donations Received into Our Office, if there is a possibility after committee review, that we are able to assist, we will reach out to you within the next 7 to 10 business days! *
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Please complete the following application to its fullest extent; any registration missing information cannot be considered for assistance. Once your Application has been received in our Office you will receive an Confirmation Screen. If you do not receive a confirmation screen, please EMAIL our office for confirmation of your application being received. Please DO NOT Re-Apply Again unless requested by the organization. *
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If you are Applying from the Columbus Area - PLEASE STOP HERE! Asa’s Angels is Over 3.5 Hours Away from Columbus. We are located in Northeast Ohio at 2709 N Ridge Rd Painesville, OH 44077 .. Our organization shows up online as if its an organization near the Columbus area, but that is NOT Correct.  If you are Located within Lake, Ashtabula or Geauga Counties, We are in your Service Area and Please continue with your Application. *
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