“Helping Hands” Compassion Outreach

Application Form

Name __________________________________ Phone

______________________________

Address
__________________________________________________________________

Name submitting request (if different than above)

____________________________________

Date work completed: _______________________

Type of Work done (describe in detail):

__________________________________________

_____________________________________________________________________________
_

Landscape Construction Cleaning Plumbing Electrical Hauling

Spiritual assessment (see below) __________________________________________________

0=Unable to assess spiritual status
1=No church affiliation, not interested in hearing about Christ
2=Open to hearing gospel, has not accepted Christ
3=Has accepted Christ, attends church sporadically, no church home
4= Regularly attends another church
5=Attends E Free Church regularly/ is member

Spiritual follow-up or Prayer requests? ______________________________________________

Suggestions…As far as spiritual follow-up, possibly concentrate on using any physical/work needs to use
as a door to those in the #1 category, sowing seed into their lives. For the #2s, we could offer a social visit
if no further work/needs were present. We would invite #3s to E Free, assisting with transportation if
needed, when appropriate and possible. Just some ideas to consider.

Follow-up “household tasks" or "Special requests"? ___________________________________

As far as the cleaning goes, doesn’t refer to regular house cleaning, however, if someone has a 1 to 2 visit
need, for example, cleaning an attic or garage, or a one-time deep cleaning request, that would be
appropriate.

Follow up date / contact type: _____________________________________________________

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