COVID Response Form

Covid may have required closing our doors for a time, but thankfully the Church is not a building. Please take a moment to fill out this survey if you are able to serve our Lakewood family or the community OR if you, or someone you know, is in need of anything. Someone will connect with you asap.

I am filling this form out for:

*

Please select one option.

Myself Someone else (if so, please complete below with their information, and add your contact info to comment box at end)

Name

*

Email

This address will receive a confirmation email

Phone

*

Address

*

I have or can provide:

Please select all that apply.

Delivery of food or necessary supplies Childcare (in your home) for a family's children General time or labor Interpersonal Connection & Communication (i.e. calling isolated individuals) Tutoring or educational Assistance Wifi access

I need or would benefit from:

Please select all that apply.

Delivery of Food or necessary supplies Childcare for my children Someone to talk to Tutoring/educational assistance for myself or my children Wifi access

Additional comments:

Description

Covid may have required closing our doors for a time, but thankfully the Church is not a building. Please take a moment to fill out this survey if you are able to serve our Lakewood family or the community OR if you, or someone you know, is in need of anything. Someone will connect with you asap.

Please Fix the Following

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