V'ahavta - Request for Assistance
We at Congregation Agudas Achim are particularly mindful of those in our community who may need assistance during this time of caution for our health. Please let us know how we can be supportive of you or someone you know.
Name *
Email *
Home Phone Number *
Cell Phone Number *
I'd like a member to check-in with me *
My preferred mode of contact is
I request help with grocery shopping *
I request help with other errands *
I might also need assistance with:
Never submit passwords through Google Forms.
This form was created inside of Congregation Agudas Achim. Report Abuse