Gas Card Request

When funds are available, we can help with gas cards for the purpose of traveling to other towns for Doctor and/or hospital visits.  Before you can receive the gas card(s) you must provide us with proof of the appointment with a signature of authorized personnel.  Please fill the following request form out at least 3 days in advance of your appointment.  If this is an emergency or you have special circumstances, please contact God's Country Community Ministries directly.

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Standard amount per person is $25.