Request for Assistance Forms

Request for Assistance Form – PDF format has to be printed and completed handwritten.

Request for Assistance Form – Word (doc) format, if you have Microsoft Word, can be filled in using the text boxes in the document and emailed to

Either document can be printed, scanned and sent via email to the emails provided in the application.

R4RAdditionalassistancelist (2)

Assistance Form pg 1 10-5-18

Assistance Form pg 2 10-5-18

ARC Chairman:

Lisa Ost

Committee Members:

Jim Fowler: 251.605.0936

Scott Hamilton: 251.689.6703

Lisa Lee: 251.377.4851

Lisa Ost: 251.391.0713

Terry Overlock: 207.841.7034