Can I get some help? If you are in need of assistance at this time, please complete the form below, and we will get back to you. Thank-you. Janet Pastoral Team Church at CCC Get Help Your Name (required) Your Email (required) Your Telephone Number (required) Your Address (required) Gender (required) MaleFemale Age Range (required) 16-2525-4040-6060+ Are you self isolating? (required) Yes - I live alone and I am unable to leave my homeYes - I live with my family and I am unable to leave my homeYes - I live in a shared house and I am unable to leave my homeNo - I can leave my home for essentials & exercise What help do you need? (required) Tick as many as apply I would appreciate a phone callI would appreciate a video callI would appreciate some help getting set up on Zoom etcI would appreciate some help in getting access to livestreamRegular prescription deliveryPosting LettersDog WalkingFood DeliveryErrands (Please specify)Other Specific Needs (Please specify?) Any Additional requests How can we pray for you? Data Protection (required) I give ongoing consent for Church at CCC to store my data We will only use your details to put you in connection with a volunteer. If you would like to know more about how we handle your details, please see our Privacy policy. https://culduthelchristiancentre.org/privacy-policy