Coastline Care Team Questionnaire

Coastline’s Care Team exists to help our members and attendees in practical ways during times of crisis, transition, illness or hardship. If you are a member or regular attendee of Coastline and would like to request assistance from our Care Team, please complete the form and click submit.

If you are member or regular attendee and are able to help meet the needs of others in the congregation, please complete the form and click submit.

Thank you!

Name

This address will receive a confirmation email

Phone

Address

I am a

Please select one option.

Member of Coastline Regular Attendee of Coastline

I would like to request help with

Please select all that apply.

Light Housework Light Home Repair Shopping Assistance Lawn/Garden Care Transportation Meals Home Visitation Other

I am able to help others with

Please select all that apply.

Light Housework Light Home Repair Shopping Assistance Lawn/Garden Care Transportation Meals Home Visitation Other

Okay to share contact info?

Please select one option.

YES. You may share my contact information with Coastline members and regular attenders. NO. Please don't share my contact information. I would like the Care Ministry to contact me.

Coastline Care Team Questionnaire

Description

Please Fix the Following