The information in this form will be kept confidential. Please contact us if you have any questions.Please enable JavaScript in your browser to complete this form.Name *Address *Work/Cell Phone *Email *Have you received COVID Financial Assistance from the WHY Church before? *NoYesIs the WHY Church your church home? *YesNoAre there any specific ways we can be praying for you? *CommentSubmit Like Tweet +1 Pin it