Apply – Exodus Ministries

Please complete the form below to begin the resource request process. Once completed, one of our team members will be in contact to continue the process.

Resource Request Form

Need(Required)

Need Delivery?(Required)

Do You Have Transportation?(Required)

Name(Required)

First Last

Address(Required)

Street Address City State ZIP Code

Phone(Required)

Email(Required)

Total Number in Household(Required)

Number of people in household ages 0-5

Number of people in household ages 6-17

Number of people in household ages 18-59

Number of people in household ages 60+

How many people in household that are veterans?

Consent

By checking this box, you agree to receive SMS messages about food box deliveries, appointment reminders, follow-up messages, transportation scheduling, changes to programs and services, or scheduling appointments from Exodus Family Ministries. Reply STOP to opt-out at any time. For help, contact us at info@exodusfamilyministries.com or (502) 614-8544 extension 103. Message data rates may apply. Messaging frequency may vary. See our Privacy Policy here: and SMS terms and conditions