Your browser does not support JavaScript!
This form cannot automatically check that you have submitted all of the required fields without JavaScript.
Please be sure to submit all required fields (marked with stars).

Birmingham Alabama Stake

Welfare and Community Relief Request Form

This form is for the request for service or relief for church members or individuals in present need within the
Please fill out this entire form.
* Priority of Request Urgent     Intermediate     Minor    
* Name Person Filling Out This Work Order
* Home Owners Name:
* Location Form
Verify boundaries this home is located within
Birmingham Ward    
Leeds Ward    
Altadena (Spanish) Ward    
Anniston Ward    
Cahaba Heights Branch    
Gadsden Ward    
Gardendale Ward    
Locust Fork Branch    
Oxford Branch    
Sylacaugua Branch    
Talladega Branch    
Vestavia Hills Ward    
* Street Address
  GPS Location
Please place gps coordinates if known
  Additional Directions To Home
* City and ZipCode
  Home Phone
Area Code and Number
  Cell or Alternate Phone
area code and cell number
* Person Status First Responder     Community Member     Ward Member    
* What Organization, Locality, or Ward is This Homeowner Associated With?
* Home Owner Authorization
Has The Home Owner or Home Owner Representative Authorized The Following Release:
RELEASE: I hold the volunteers, including their representatives and agents, harmless
from any damage or injury that may occur on my property, including personal property.
Further, I understand that no warranty or guarantee, express or implied, is provided for work performed on or for my property.
yes     no    
  What is the name of the person giving authorization for work?
Assessment
  Name Of Person Making Assessment
  Is This Home or Structure Habitable? yes     no    
  Is Occupant Planning To Continue Living In Home? yes     no    
  Home Damage
Check Boxes Needed
Shingles Only
Major Structural Damage
Flood Damage
Holes In Roof
Broken Windows
Other
  Is Heavy Equipment like Bobcats, Cranes, or Bulldozers Needed To Complete The Job? yes     no    
  Specific Damage
Please describe specifics such as number of broken windows, number of holes in roof, or other related information.
  Tree Damage
Please Check What Size Trees Need Cutting.
Under 12"
Under 24"
Over 24"
  Specific Tree Information
Describe Specific Tree Work Needed
  Notes: Tools/Equipment/# of Tarps/Skills Needed and Other Helpful Information
Please detail need criteria to accomplish work.
Submission and Assignment
After work/relief orders are submitted below they can be then assigned
within the LDS-FastCommand administration area. To access the
administration area you will need to click the link at the end of the
paragraph below. A user name and password is needed. You may call
FastCommand at 205-246-0953 if you need a password, but it is best if you
rely on your stake priesthood leaders to distribute the password.

To report successful work accomplished including manpower invested, and
what was fulfilled, you will need to log into the administration area
again. After submitting any relief/work order you can write the
description and notes of work that was accomplished and by whom in the
comments section of any work/relief order. Please place your groups name,
ward/stake and notes on the work order upon access in the administration
area. Also state if the task was done, partially complete, or nothing was
needed, as well as the number of individual assisted and neighbors you participated
with. To see submitted work orders or update the assignment or status,
please go to http://lds.fastcommand.com.