Angels in Flight | 6696 County Road 200 | Florence, AL 35633 | (256) 765-9983

Application for Assistance

If you or someone you know requires assistance, please, complete the form below, detailing the specific need and why you believe Angels in Flight should address that need.

PLEASE NOTE: WE CANNOT RESPOND TO ALL SUBMISSIONS.

Due to the number of requests received for assistance, we unfortunately cannot individually respond to each one. Please know, however, Angels in Flight will review each request with diligence and sensitivity. We will treat your request with respect to privacy, but will need full name(s) and contact information for the person(s) requiring assistance, as well as that same information regarding the person requesting the assistance, so that we can act upon any and/or all approved requests.

If or when we are able to assist with a request, we will notify the petitioner and the recipient. If you have not received notification of approval for assistance, please, wait at least 30 days before submitting a new request. Thank you for understanding.

APPLICATION FOR ASSISTANCE:

Date and time of request

Month

Day

Year

Time

HoursMinutes

What is the name of the person submitting this form?

First Name of Petitioner

Last Name of Petitioner

Petitioner's Phone

Petitioner's Email

What is the Name of the Person Requiring Assistance?

First Name

Last Name

Phone

Address/City/State/Zip

Is the person requiring assistance employed? If so, where?

Unemployed

Disability

Employed (if so, note below)

Current Employer

What specific type of assistance is being requested, and what is the reason for the financial hardship? Please, be as detailed as possible.

Details

Please, list all members of the household along with the birthdates of each individual:

Household and Birthdates

Please, provide 3 personal references outside of the household. Only one reference may be a friend or family member. Include at least one professional reference. Names, association to each person, and phone numbers are required.

Reference 1

Reference 2

Reference 3

What other agencies are currently providing assistance?

Agencies Currently Assisting

Is there any additional information you wish to share which you think may be helpful in our review process?

Notes

501c3

Angels In Flight • 6696 County Road 200 • Florence, AL 35633

(256) 765-9983

Angels In Flight is a 501c3, a duly organized non-profit corporation, and all contributions are tax deductible. Angels In Flight is overseen by a Board of Directors and a financial statement is available upon request. Documents and details are available via BRAVO Properties.

Donation checks can be made out to “Angels In Flight” and sent to: Angels In Flight, 6696 County Road 200, Florence, AL 35633

Angels in Flight | 6696 County Road 200 | Florence, AL 35633 | (256) 765-9983

Application for Assistance

APPLICATION FOR ASSISTANCE:

Angels In Flight • 6696 County Road 200 • Florence, AL 35633 ​ (256) 765-9983

.

Angels In Flight • 6696 County Road 200 • Florence, AL 35633

(256) 765-9983