Wheelchair Ramp Ministry

Sunday Worship at 8:30 & 11:00

1630 Statesville Blvd. Salisbury, NC 28144

704-636-0471 - info@milfordhillsumc.org

Is the location a Mobile Home? *

Agency's Name

Recipient's Phone *

Contact's Phone

Agency's Address

APPLICATION FOR WHEELCHAIR RAMP

Contact's Name

Recipient's Name *

Referral From

Other: Please specify

Worksite actions requested

Wheelchair Ramp

Steps

Handrails

Other

We usually don't think twice when we enter and exit our homes, but for those that are wheelchair-bound, it can be a difficult task. A wheelchair ramp ministry can provide easier access and increased mobility for those that have disabilities as well as those that are aging in Salisbury while we share the love of Christ with them to make disciples for the transformation of the world. This is a new ministry we hope to begin in January of this coming year. Our vision is to provide accessibility, increased mobility, and better quality of life for those that have this need within the city of Salisbury. We plan to receive referrals both online and on paper through our church office.

Describe Recipient's Medical Conditions *

Other: Please describe

Language Spoken:

English

Spanish

Other

Referral Phone

Recipient's Age *

Best Time to Call Contact Person

Wheelchair Ramp Ministry

Other: What language

Please do not apply under the following conditions:

If you are on Medicaid that agency should be your first resource. If you are turned down please attach a copy of their response when you apply.
If you live outside of the city of Salisbury, NC.
If you are a veteran the VA should be your first resource. If you are turned down please attach a copy of their response when you apply.
If your need is beyond our capability or ability to do the work safely.
If your need is short-term (less than 1 year).Please note that preference will be given to applicants who own their own home or who are purchasing their home

Does Recipient own home or is buying the home? *