Community Assistance Request Form

Ghana Girls Connect is committed to supporting our community during this challenging time. We understand that recent changes to SNAP benefits have left many families in need of food and financial support.

Through this program, we’re offering food, sanitary, and monetary assistance to those in need. Please note that donations are community-funded, and availability may vary based on the level of support we receive. While we may not be able to fulfill every request fully, our team will do our best to provide some form of relief or connect you with additional local resources.

Please complete the form to request assistance. Our team will review each submission and contact you within 1-2 business days regarding available support.

All information will remain confidential.

If you have any questions, please feel free to reach out to us a info@ghanagirlsconnect.org or outreach@ghanagirlsconnect.org

Name

First Name

Last Name

Phone

(###)

###

####

Address

If you aren't local to the DMV, this is needed so we can mail you supplies if necessary.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

How many people are in your household?

Number of children

If you don't have any children please put zero. This doesn't disqualify you from receiving assistance.

Briefly describe your current situation and how we can best support you.

Please select the type of support you’re requesting:

Food Assistance

Cash Assistance

Both

Preferred method to receive assistance:

CashApp / Zelle / PayPal Username or Email (optional until verified)

I confirm that the information provided is accurate and understand that submitting this form does not guarantee assistance.

Community Assistance Request Form

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