God's Changing ' Woman' Ministry
We're Here. We Exist. And, There's Hope!
What services do you need? Supportive Housing ____ Affordable Housing ____Job Training Skills ___ Health & Nutrition ___Computer Training___ Pastoral Counseling ___Parenting Classes___ Support Group _____
Name: ________________________________________________________________________________________Address: ______________________________________________________________________________________Home # ______________ Cell# _______________ email: ___________D.O.B. __________________ Educational Level: ____________________
Are you employed?: Yes ___ N0 ___ (If No) What Financial Assistance do you receive? ________________________________Services requested are: Voluntary _____ Court Ordered _____ CPS Ordered _____
Date:______________________
Save your application and email it to urbanpreacher5@aol.com
