NEEDS REQUEST FORM

Thank you for reaching out to Branches Ministries, we look forward to meeting with you soon. Upon completion of this form, a Branches representative will contact you to set up a meeting to further discuss how Branches can assist you. All need requests are processed upon submission of this form, please allow 24 for a Branches representative to contact you.

ABOUT THE REQUEST

IN WHAT OTHER WAYS MAY WE PROVIDE SUPPORT FOR YOU:
 
WOULD YOU BE OPEN TO RECEIVING FINANCIAL MANAGEMENT CLASSES: *

CAR REPAIRS

*****For car repair ONLY, skip to next section if not applicable.

Branches Confidentiality Notice & Discontinuation of Services Disclaimer

Any personally identifiable information supplied by you will NOT be shared outside the reference of Branches Ministries staff, unless written permission is given and documented. Names and contact information may only be used by Branches Ministries for contacting purposes, and will not be sold or otherwise transferred to unaffiliated third parties. Your signature below allows Branches to offer you assistance in the event it is needed with a promise of confidence.

Due to these strict confidentiality policies and our contract with NGU, Branches Ministries reserves the right to make changes to services without notice to the families or staff of Never Grow Up. In the event of termination of employment and/or dis enrollment, services provided by Branches Ministries may be limited due to a conflict of interest. Financial assistance depends on financial availability as well as the terms of exit and/or termination.

Branches Ministries shall not be held liable to any party as a result of mis-information, breach of services or contact with resources made available through Branches Ministries. Branches Ministries does not endorse any information provided for financial gain and does not provide any warranty regarding the accuracy or any other aspect of the information provided by Branches Ministries or any other affiliated resources.

I, the undersigned, in full recognition and appreciation of participation, do hereby agree to assume all the responsibilities surrounding and permitting to my participation with Branches Ministries. Further, I do for myself and my families personal representative(s), hereby agree to defend, hold harmless, indemnify, release and forever discharge Never Grow Up, Inc. and Branches Ministries from against any and all claims, demands and actions, or causes of action, on account which may result in participation with the organization or any assistance received, including any causes beyond the control of, and without the fault of negligence of, Never Grow Up, Inc. and Branches Ministries during the period of my participation.
Signature: *
clear

captcha
Powered byFormsite