Parklawn Assembly of God Community Support & Partnership Form Step 1 of 4 25% Today's Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201. First and Last Name* First Last 2. Phone Number*3. Email Address* 4. How are you connected to Parklawn Assembly of God?MemberCommunity MemberFirst Time Guest If you are requesting a support, please complete questions 5. If you are donating resources/support, please complete questions 6-9. 5. Are you requesting support/help?YesNo*If yes, what type of support/help are you requesting Prayer Benevolence Acts of Service Parent/Caregiver Resources Food & Supplies Other * If other(please specify the details of your request including how this need impacts you or your family in the box below) 6. Are you able to meet a need? Donation of Supplies Please specify: (i.e. toilet paper)Financial Contribution (Food Drive)parklawn.org/give/ CashApp: $PAOGMKE (Please include your first and last name and Food Drive in the Notes Section)Acts of Service Drive Thru Prayer Food Drive Care Calls Media Support Meeting the Needs of Others Provision of Professional Services (Please Specify, i.e. plumber donating hours) 7. Are you an organization that is seeking to partner with Parklawn Assembly of God?Yes*No*If yes, please specify in detail8. Can we text or email you if there are other needs within our community that have not been specified above?YesNo9. If you have another way to serve our community during this time of need, please explain below.