Kingdom Cares Help Request Form

Kingdom Cares was created to provide help and care for Kingdom Culture’s individuals and families who are experiencing big transitions and/or emergency situations. You can fill out the following form for yourself or someone who is in need, and Kingdom Cares will do what it can to provide care.

Your name *

Last name

Email address *

Phone number *

Phone type

Address *

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

How would you prefer to be contacted? *

Phone

Text

Are you filling this form out on behalf of someone else?

Please check this box if you are filling out this form on behalf of someone else

Assistance Needed

How can we help? *

Please select all that apply to the person’s situation (you can check multiple boxes if needed):

Meals (e.g., meal delivery, meal prep)

Transportation (e.g., to appointments, grocery store, etc.)

Childcare (e.g., for a few hours, regular help, etc.)

Errands (e.g., picking up prescriptions, groceries, etc.)

Grocery or supply delivery

Emotional or Spiritual support

Home repairs or maintenance (e.g., fixing a leaking pipe, etc.)

Temporary housing or shelter

Other

Detailed description of the need *

Please provide a detailed description of the situation and how we can best support the person in need. Include any relevant dates, timelines, or specific instructions.

Timing and Urgency *

When does the person in need require assistance? (Please check the box that best describes the situation)

Immediate help (within 24 hours)

Within the next few days

In the next week or more

Flexible timing

Other

Additional Information or Requests

Is there anything else Kingdom Cares should know in order to provide better support? Feel free to share any preferences, limitations, or special instructions.

Preferred Method of Communication *

How would the person in need prefer to receive updates or follow-up communication?

Phone

Text

No preference

Through the person who submitted the request

Confirmation & Consent *

By submitting this form, I agree Kingdom Culture Church - Kingdom Cares Team may contact me for assistance on behalf of the individual(s) listed above.

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Kingdom Culture
admin@kingdomculturechurch.com
2487272994

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