Operation Uplift - Kids Sleeping on the Floor No More

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This ministry of M1 Church is providing beds for in the North End of Mansfield.

Fill this form out to start the process. If you have multiple children who qualify, please submit the form once for each child.

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Does your child meet all the qualifications listed below? (Please check all that apply) *

Elementary age or younger

Without a bed of their own

Live in the North End of Mansfield (see graphic below)

Available floor space of 8x4 feet for the bed

Permission for our team of 3-4 people to set up the bed in your home?

Child can be present upon delivery of bed

Pflichtfrage

What is the name of the child's main contact parent/guardian? *

What is the textable phone number of the child's main contact parent/guardian? *

What is the official address for the child and where the bed would be delivered and set up? *

The North End

If you were able to select all of the requirements of the previous question, please continue with the rest of this form. (If not, we apologize. Thanks for understanding the limited scope (ages, location) this ministry has due to our capacities. *

My child meets all of the requirements in the previous question.

They do not meet all the requirements at this time.

What is the child's first name? *

What is the child's last name? *

What is the child's age? *

3 years old

4 years old

5 years old

6 years old

7 years old

8 years old

9 years old

10 years old

11 years old

12 years old or older

Pflichtfrage

What is the child's gender? *

Female

Male

We are a church and our goal is to go beyond providing and setting up the bed and mattress. We also plan to minister and pray with the recipients. Would you allow us that opportunity? If not, this does NOT disqualify anyone. *

Yes, I'm good with the church praying for us upon delivery of a bed.

No thank you.

Is there anything else you'd like for us to know? *

Senden

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