UTILITY ASSISTANCE SERVICE
THANK YOU FOR CHOOSING GRACE BIBLE CENTER FOR  
YOUR  UTILITY ASSISTANCE SERVICE NEEDS.

PLEASE COMPLETE THE FOLLOWING QUESTIONNAIRE SO
THAT WE MAY BE ABLE TO ASSIST YOU IN RESTORING
YOUR UTILITY SERVICE.
Please tell us about your previous service/ and  or
application for service through Grace Bible Center
Which utility company did
you apply for assistance for?
Your name:
Email:
Service
Address:
Telephone:
What was the final outcome? Service restored, Found another source, etc.
(Please type your final outcome below)
PLEASE NOTE: GRACE BIBLE CENTER WILL CONTACT YOU
WITHIN 48 HOURS REGARDING YOUR REQUEST