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?
What was the outcome when you have sought assistance from family or home church?
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
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