Dollar Club Request Form

Before proceeding with this form, please consider the following:

• Is this a request that could be met by our Care Center (food, clothing, dental, car resources) or Community Resource Days (resources for those facing homelessness)?
• This form is intended for individuals requesting on behalf of someone else. If you are requesting on behalf of yourself, instead of submitting this form, please first visit our Care Center or Community Resource Days.

Financial assistance is just one way that we offer support here at Willow, please see this list of expanded resources for more information: Financial Resources

Although we cannot provide funding for every Dollar Club submission we receive, we will review each request. Thank you for your patience! We will contact you if we have further questions or if your request has been selected.