Page 31 | Home Church Andalusia, AL

Summer Outreach

We will make every effort to meet the needs shared with us, and it is our desire to support every family as best we can. However, resources may be limited at times, and we may not be able to fulfill every request in full. We appreciate your understanding and are committed to walking alongside you with care and respect. Please note that the deadline to complete this form is June 14, 2025.

Jesus is the Answer!

Name (Required)

Email Address (Required)

Your Phone Number (Required)

Your Address (Required)

Total number of people in your household? (Required)

Number of Adults (18 +)? (Required)

Number of individuals under 18? (Required)

Ages of children under 18? (Required)

Which items would be helpful to your family over the summer? (Required)

Groceries / Food pantry items

Fresh produce / perishables

Hygiene products (toothpaste, soap, shampoo, etc.)

Baby items (diapers, wipes, formula)

Other (please specify below)

Other Items as indicted above (Required)

Do you or anyone in your household have dietary restrictions or allergies? (Required)

If allergies indicated, please list. (Required)

If none, please type none.

Is there anything else you’d like us to know or ways we can help your family?

Prayer Requests

How can we pray for you?

I would also like more information on

Let us know if you made a decision today or if you want us to follow-up with you.

Committing my life to Jesus

Renew my commitment to Christ

Get baptized

Information about Home Church

Home Church Andalusia, AL

101 Adellum Drive
Andalusia, AL 36421

homechurchandalusia@gmail.com

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