Assistance | samanthaspurpose

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Request for Assistance

Assistance Needed: (mark all needed)

Groceries

Incontinence Supplies

Medical Supplies

Personal Hygiene Supplies

Respite Care

Financial Support with Therapy

Financial Support with Summer Camp

OTHER Assistance Request

I acknowledge that my personal information and application for assistance will be kept confidential. By submitting this application, I confirm that my information will be added to the organization's email list. I further acknowledge that the completion of this Application does not guarantee I will receive the assistance requested. This is the first step to the approval process.

Thank You for your submission! We will be in touch with you shortly to discuss how we can assist you.

CONTACT >

E: info@samanthaspurpose.org

Samantha's Purpose, Inc. is a Section 501(c) (3) charitable organization, EIN 26-1567901. All donations are deemed tax-deductible absent any limitations on deductibility applicable to a particular taxpayer. No goods or services were provided in exchange for your contribution. A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE 1-800-HELP-FLA OR ONLINE AT www.FloridaConsumerHelp.com, REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.” REGISTRATION #: CH29224

© 2023 by Samantha's Purpose, Inc.

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