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 arcchair@r4rmobile.org.

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