🤲 Disciples On Demand Assistance Request Form

“Meeting the need. Restoring the soul.”

We believe every need is an opportunity to show the love of Christ. Whether you're facing a lack of food, clothing, hygiene products, or struggling with life situations—you are not alone.

This form is for those seeking physical assistance and a deeper connection through prayer, discipleship, and spiritual guidance. We serve men, women, children, individuals, and families—including those needing restoration in marriage, parenting, and personal purpose.

💡 What kind of assistance are you seeking right now?

(Check all that apply)

📄 Briefly describe your current situation

What’s going on in your life that brought you to seek help today?

🧔👩👶 Who is in your household or under your care?

(Select all that apply)

⛪ Are you currently connected to a church or ministry?

📅 Do you need ongoing support or is this a one-time need?

🔒 Acknowledgement & Agreement

By submitting this form, I understand that all support is based on availability, need, and the mission of Disciples On Demand Inc. I welcome spiritual support and agree to be contacted

📩 Next Steps

Once your form is submitted, our team will prayerfully review it and contact you. We aim to not just respond—but walk with you in love, truth, and restoration.

📧 afountain4christ@disciplesondemand.org

🌐 www.disciplesondemand.org

📞903.819.1971

“The goal is not just relief—it’s redemption. Let’s rebuild, together.”