SB assistance request — Ecumenical Ministries of Baldwin County, Alabama

Request for Assistance

If you need help and live in Foley, Elberta, Lillian, Magnolia Springs, or Bon Secour, please complete this form.

Name

First Name

Last Name

Email Address

Phone

(###)

###

####

What city do you live in?

(Required)

What are the last four digits of your Social Security number?

What type of assistances do you need?