Batavia Covenant Church Assistance Form
We want to be able to assist you in any way we are able! Help us to know who you are by filling in the questions below. Thank you!
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Email Address/Contact Information *
Phone Number *
Help and Support
What do you need right now? How can we support you?
Please check the following boxes in which you may need support. *
Additional Requests or Details
Provide any other or additional information so we can best help you.
How else can we help you during this time?
Prayer Requests
Would you like your prayer request to be shared with the church's prayer team?
Clear selection
Clear form
Never submit passwords through Google Forms.
This form was created inside of Batavia Covenant Church. Report Abuse