Furniture Request Form — WeDo Good Works

Living Room

Kitchen

Dining Chairs Number:

Only fill out if you clicked dining chairs. Put N/A if this does not apply to you.

Other:

Only fill out if you clicked other for kitchen. Put N/A if this does not apply to you.

Bedroom

Other:

Only fill out if you clicked other for bedroom. Put N/A if this does not apply to you.

Bathroom

Choose which bathroom items you need

Write in for this question what bathroom things you would need.

Bedding

Other:

Only fill out if you clicked other for bedding. Put N/A if this does not apply to you.

Confirming Signature

By signing this I am acknowledging that all information I have entered is correct and honest to my best knowledge.