Request Form (English)

REQUEST FORM

*Please note: All requests will take between 48 to 72 hours to be completed. If you are submitting this form on a Friday, you might not receive a response until Monday (if this is an emergency situation, please make note of the emergency)

Please fill out the contact information below with the information for the person we should contact; Our Outreach Specialist will review this request and contact you at the phone number provided. Enter N/A if not applicable do not leave blank.

4 The Love Foundation currently serves Thurston County residents only.

Requestor's First and Last Name (Indicate 'Self' if applying for oneself)

If you are filling form out on behalf of someone else, please include YOUR contact info here.

I am making this request on behalf of a relative/friend/neighbor/co-worker

Yes

No

I am employed at a non-profit agency, a school or a church and I am making this request on behalf of a client/student/member

Yes

No

Please list the name of the agency, school district, or church below

I currently reside in Thurston County. (Applicant)

I am making this request for myself and/or my children?

Yes

No

First name (Person requiring support)

Last name (Person requiring support)

Phone (Person requiring support)

Email (Person requiring support)

Children's ages.

Schools they are attending.

I DO NOT want the Outreach Specialist to leave a voicemail or text

*To process and make a decision on your request, we may require additional documentation.

**Please be advised that lease agreements are required for rental assistance requests.

If you are working with another organization, I authorize 4 the Love Foundation to communicate with them on my behalf. If this applies, please complete the Release of Information (ROI) form available on our website.

THIS SECTION IS REQUIRED FOR US TO MAKE A DECISION. Please note we will not process your request if this section is not filled out with detailed information about your request.

Please provide a summary of your request

Do you or your family currently feel safe at home?

Yes

No

Prefer not to answer

If you were referred by another organization, please provide the name and phone number of your case worker below.

How did you learn about our organization?

REQUEST FORM

A 501(C)(3) nONPROFIT- EIN 84-3500182