Application for Assistance

Name

First Name

Last Name

Email Address

Phone

(###)

###

####

What is the best way to contact you?

In what area(s) are you seeking assistance in?

Prayer

Recovery/Addiction

Guidance/Coaching

Emotional support

Food/Shelter

Other

If you clicked "Other" in the field above please explain.

If you need support, we are here for you.

Please submit this application and a team member will reach out to you shortly. Contact us at info@ghproject.org or call 610.874.2753 with questions.