I HAVE A NEED

Thank you for contacting us with your needs. Someone will contact you soon with information about meeting your needs. In the meantime, how can we pray for you? If you would like prayer, please go back and select the prayer button to submit your request.

CONTACT INFORMATION

FIRST AND LAST NAME
PHONE
EMAIL
ADDRESS (Street, City, State, & Zip)

DO YOU HAVE TRANSPORTATION?

WHICH AREA OF NORTH CAROLINA DO YOU LIVE IN?

HOW CAN WE HELP YOU? 

Please list the need(s) you need met below. Please be specific where possible. 
PRIMARY NEED
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