DDM General Request Form

Complete this form to help us learn how we can best serve you.

Personal Information

First name

Last name

Phone

Email (if available)

Birthday

Month

Day

Year

Address (Optional but helpful)

Household Information

Number of people in your household

Are there any children or elderly in your household?

Children (under 18)

Elderly (65+)

Both

Neither

Immediate Needs

Services Needed in Completion

What are you requesting help with today?

Further or long-Term Goals

What are some personal goals or desires you have?

Preferred Contact Method:

Call

Text

Email

Best Time to Reach You:

Morning

Afternoon

Evening

I give Deliverance Driven Ministries permission to contact me regarding support and follow-up.

LATEST
PROJECTS

Through God’s grace, we are building programs that restore dignity, empower families, and spread hope. Here are our latest projects and initiatives:

THE LAZARUS PROJECT

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PROMISED PROVISION

D.I.D - Dining in Discipleship

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ETP - ENTREPRENEURSHIP

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THE TABLE KIDS

CROWN & CARRY - ELDERLY ASSISTANCE PROGRAM

Crown & Carry - Elderly Assistance Program

The Table Kids

Fellowship Programs and More

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HOUSE OF DELIVERANCE - Bible Group (GroupMe)

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