Care Group 5 Member Needs/Notification
This form is meant to be a means of communication for the members of the church of Christ at East Side (Austin, TX) to communicate their needs to the leaders of Care Group 5. Please fill out the form as completely as possible.

We will attempt to contact you within 72 hours of form submission. If there are any immediate needs, please contact us by phone (Timothy Arnold - 469-777-6106, Paul More - 512-589-0350)

First Name *
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Last Name *
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Contact Information
Please provide detailed information so that we may contact you regarding the need.
Address
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Zip Code *
Email
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Phone Number
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Preferred Means of Contact *
Need Description or Question *
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