Non-Profit 501(c)(3) Charity Organization
4130 24 Mile Road
Shelby Township, MI 48316
586-254-3123
www.extendedhandcharity.org
extendedhand@comcast.net

Request For Help

            
PLEASE CONTACT 211 OR UNITED WAY OR YOUR LOCAL CATHOLIC CHURCH , OR GOODFELLAS - WARREN

WE ARE NOT TAKING REQUESTS AT THIS TIME



Please list the FIRST and LAST name plus the AGE and SEX of EACH member of the household 
Also If you are a single mother or father. senior citizen, or senior couple and a brief reason for request

First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)


Daytime Phone:
Evening Phone:
Email:
Family Members:
Comments:

Extended Hand Inc.
4130 24 Mile Road
Shelby Township, MI 48316
(586) 254-3123
extendedhand@comcast.net