Deacons Request Form
First Name
Last Name
Address
Apartment, suite, etc.
City
State
Zip/Postal Code
Email
Phone Number
Have you contact others for Assistance?
Family
Friends
Other Churches
Other Orginazations
I haven't contacted anyone
What is your home Chruch?
How long have you attended?
Assistance Request?
When is assistance requested?
I understand that the Calvary Ellensburg Deacons will attempt to assist me in addressing my current needs. I agree to indemnify or hold harmless Calvary Ellensburg, its employees or volunteers, etc. from any claim, action, demand or liability of any kind or nature rising out the service/aid they provide.
Agree
Do not Agree
What was the outcome when you have sought assistance from family or home church?
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