St James Care

First Name

Last Name

Email Address

Mobile Number

Suburb you live in:

Service you attend:

Growth Group you are in (if applicable):

I need a helping hand.

Indicate below how we might be able to offer assistance to you at this time. We will help within the constraints of the NSW government health guidelines on social distancing.

I feel fine but I would like to chat and pray with someone

Yes

I am unwell or self isolating and would like to chat and pray with someone

Yes

I am unwell or self isolating and would like some practical help

Yes

I am unwell or self isolating and need help with food or pharmacy supplies

Yes

Other information or requests that we might be able to help you with:

I'd like to lend a helping hand.

Indicate below how you might be able to assist other members of the St James Croydon community at this time.

I would be willing to call someone to chat and pray with someone who is unwell or self-isolating.

Yes

I would like contact from a staff member about how I might be able to provide practical support for those who need it.

Yes

I have another idea for how I might be able to help.