Requests for AssistanceWe are here to help! Please fill out the following to the best of your ability. We will contact you as soon as we possibly can. -Molalla Cares Team Your Name (if requesting for someone else, their information comes later) * First Name Last Name Your Email * Phone * (###) ### #### Are you requesting assistance for yourself or a community member? * For Myself Community Member If the request is for a community member, please provide the name: Please give specific details on what assistance is needed: * Address and contact information of the person/people who need assistance: What's the best way to contact you and best time to reach you: * Thank you for your submission! Our team will contact you as soon as we can!
