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Referral Form 2017-06-30T01:23:38+00:00

Helping Hands Referral Form

Dare to Care!

Helping Hands of America Inc. Non-Profit Organization (501 (c)3) Charity

Questions: Contact Executive Director, Kim Donadio
Email: KimDonadio71@gmail.com
Facebook: http://www.facebook.com/groups/611535985667665
Twitter: http://www.gofundme.com/helping-hands-of-america-help-kids

Referral Issued: _____Y/N____________ Date Issued: _________________

Agency Issued: ____________________ Reason: _________________

Clothing check all needed Homeless
Baby Items Low Income
Furniture Event Drive (fire/accident/flood/sickness)
Household Goods Abuse/Neglect, Elderly, Other

Helping Hands Internal Use

_______________________________________________________________

Director/Team Leader signature: _______________________

Date:______________________

Tax ID: _______________________

 

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